GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 007/WEB/VI/2025

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 82 PAPER PINDOPLUS

Problem :

-FLUI

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 6.708.000.-

In Words

( Enam juta tujuh ratus delapan 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 ID ROLL: 082501023P	559 KG	FLUI / BERGELOMBANG
NO.DO	D1L0075387

Jakarta, 18 Juni 2025

Prepared by,

Checked by,

Approved by,

18-06-2025

( Gita Siti )

18-06-2025

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )