GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

DIC Graphics

Complaint No. :

Address

CIF No.: 001/SHT/I/2025

Phone

PIC

Invoice No. :

PO

Quality Order

Product : TINTA PROSES SHEET

Quality Complaint

Specification : TINTA SYNER-G EX PLUS MAGENTA

Problem :

TINTA KERING, TERJADI PADA SAAT PERGANTIAN KALENG (DIREKOMENDASIKAN MENGGUNAKAN KALENG YANG SEBELUM NYA)

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 1.032.000.-

In Words

( Satu juta tiga puluh dua ribu 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 :

NO.DO	824143077

Jakarta, 23 Januari 2025

Prepared by,

Checked by,

Approved by,

23-01-2025

( Gita Siti )

23-01-2025

( Maurina Gurning )

( ........................ )

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )