GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cinjoejaya Perkasamuda

Complaint No. :

Address

CIF No.: 010/WEB/IV/2024

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 73 RAP PREMIUM

Problem :

-CORE RUSAK        (PEYANG)

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 6.220.800

In Words

( Enam juta dua ratus dua puluh ribu delapan ratus rupiah )

Ect ..................................................................................................................................

Data :

Original sample / before process	Copy of DN
Sample after process	Photo
Comparison sample	Packaging
Inspection Card	Pull Tape ( for Picking / Dusting problem )
Ream Label
Ect

Notes :

ID ROLL 3143350386, 	NO.DO	SJ23036/18822 TGL 20/12/2024

Jakarta, 25 April 2024

Prepared by,

Checked by,

Approved by,

25-04-2024

( Gita Siti )

25-04-2024

( Maurina Gurning )

25-04-2024

( PT.CINJOE JAYA )

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )