GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Heidelberg Indonesia

Complaint No. :

Address

CIF No.: 001/PRP/III/2025

Phone

PIC

Invoice No. :

PO

Quality Order

Product : 96 LEMBAR

Quality Complaint

Specification : PLT 889X576X0.3 NC@50

Problem :

PLATE JENIS NC UKURAN 889 X 576 MM BEDA KETINGGIANNYA DALAM 1 BOX (PLATE POTONGAN)

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :

In Words

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

Ect POTONGAN TIDAK PRESISI

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 :

MOHON BARANG DITARIK KEMBALI KE HEIDELBERG

Jakarta, 08 Maret 2025

Prepared by,

Checked by,

Approved by,

08-03-2025

( Nurul )

08-03-2025

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )