PT. LPS Indonesia

CLAIM FORM
CF-70564


Jobfile : 12507225
Employee name : CV BERLIAN SUMBER CAHAYA
Department name : WORK PERMITS
Expenses for period ending : Sep 25
Item Category Description Remark/ Invoice No Date Total
UMUM MATERAI 10000 MATERAI 10000 2025-09-04 10,000.00
WORK PERMIT-CREW HANDLING FUTURE SYNTHETIC for KARIMUN. SKKOA for ELAVARASAN SUBRAMANIYAN FUTURE SYNTHETIC for KARIMUN; SKKOA for ELAVARASAN SUBRAMANIYAN 2025-09-04 2,094,200.00
 
 
 
 
 
 
 
 
  Total   IDR 2,104,200.00
  Less Cash Advance IDR 0.00
Less Company Paid IDR 0
Due to Staff IDR 2,104,200.00
I certify that the above information is complete and true and in
compliance with Company policy.
Employee Signature Date Reviewed by Finance Department Date
CV BERLIAN SUMBER CAHAYA 04 Sep 25    
Immediate Superior Signature Date Received by Date
YENNY WILLIM