GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 003/SHT/IV/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS SHEET

Quality Complaint

Specification : HVS 70 56X88 PAPER PINDO PLUS

Problem :

KERTAS LEMBAB, MENYEBABKAN FLUI SAAT PROSES CETAK

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 8.644.228

In Words

( Delapan Juta enam ratus empat puluh empat ribu dua ratus dua puluh delapan 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 :

Jakarta, 19 April 2023

Prepared by,

Checked by,

Approved by,

19-04-2023

( Gita Siti )

19-04-2023

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )