PT Gelora Aksara Pratama
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FRM.PCH.04.01/rev-3
PT. GELORA AKSARA PRATAMA
Jl. H. Baping Raya No. 100, Ciracas, Pasar Rebo, Jakarta timur. Telp (021) 8710060. Fax (021) 8710566
COMPLAINT ASSESSMENT FORM
Supplier Name
Cinjoejaya Perkasamuda
Complaint No. :
Address
CIF No.:
Phone
PIC
Invoice No. :
PO
Quality Order
Product : HVS ROLL
Quality Complaint
Specification :
Problem :
-FLUI
Kategory of Complaint
Quality
Handling
Packaging
Quantity
Delivery
Claim value (IDR/USD/SGD/EUR) :
In Words
( .................................................................... )
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 :
NOMOR ID ROLL QTY KET' RUSAK 1135393801 466 FLUI 1135393816 494 FLU NO.DO SJ25036/15481 & SJ25036/15384
Jakarta, 21 November 2025
Prepared by,
Checked by,
Approved by,
21-11-2025
( Gita Siti )
21-11-2025
( Maurina Gurning )
( ........................ )
( Staff Pembelian )
( Ka. Bag. Pembelian )
( Supplier )
Link Verifikasi Vendor :
Copy
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LAMPIRAN PCH
LAMPIRAN AKT
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