GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 002/WEB/IV/2025

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 82 PAPER PINDOPLUS

Problem :

UK FISIK KERTAS TIDAK SESUAI

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 7.541.780.-

In Words

( Tujuh Juta lima retus empat puluh satu ribu tujuh tarus delapan puluh 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: 75943917, NO DO: 	D1L0067969

Jakarta, 16 April 2025

Prepared by,

Checked by,

Approved by,

16-04-2025

( Gita Siti )

16-04-2025

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )