LA*6IZAN TRANSAKSI

BANK BRI
DIKAINDONESIA
TENGAH
Tanggal Cetak 04/01/17
A INDAH BISNIS CENTER NO. JAKARTA SELATAN CILANDAK JAKARTA
Periode 01/12/16 - 31/12/16

Halaman
No. Rekening 0428-01-000335-30-4 Unit Kerja KC CINERE
Nama Produk Giro Umum—IDR Alamat CINERE
Mata Uang IDR KWL UT 2
Tanggal Keterangan Debit Credit User ID SALDO
31/12/16 10:52:38 CA Cash Withdrawal 401,190,500.00 0.00 2044051 37,075,057,074.73
02/12/16 09:52t32 M GHUFRON VAQIH 32,000,000.00 0.00 0428052 37,043,057,074.73
32/12/16 09:52.59 M GHUFRON VAQIH 29,8F0,000.00 0.00 0428052 37,013,207,074.73
02/12/16 15:25‹09 JOSEPH TANUWLIAYA 325,000,000.00 0.00 0428052 36,688,207,074.73
02/12/16 II:50:34 1 SRT REF BANK B078KCXIVDJSII2016 PT AMI 150,000.00 0.00 0428052 36,688,057,074.73
05/12/16 10:40.01 RTGS Trf Ovb CA 186,500,000.00 0.00 0428052 36,501,557,074.73
05/12/16 15:09:52 SINERGI SAM SUKI PT—BANK JATIM 0.00 16,000,000.00 BRI0372 36,517,557,074.73
06/12/16 08:59t.26 RTGS#RSU KAB TGR 0.00 827,074,872.00 0369891 37,344,631,946.73
06/12/16 11:57:38 RTGS Trf Ovb CA 192,000,000.00 0.00 0428052 37,152,631,946.73
f’" "2/16 6 REF BANK B079-084KCXIVD3S1216 PT AMI 900,000.00 0.00 0428052 37,151,731,946.73
15:28t1i8 0 SPAN: 160041301008512000001 0.00 16,830,068,181.00 SPN410 53,981,800,127.73
2/16 15:fî4t11 0428054 1101 CA Cash Deposit 0.00 49,500,000.00 0428054 54,031,300,127.73
07/12/16 09:57t19 ARYANTO 370,000,000.00 0.00 04280?i4 53,661,300,127.73
07/12/16 10:11:17 033001000654997-TITIPAN MACAM2 PA3AK 115,603,309.00 0.00 0330054 53,545,696,818.73
07/12/16 10:1850 CA Cash Withdrawal 345,000,000.00 0.00 0428053 53,200,696,818.73
08/12/16 13:30)42 2138847 82,369,980.00 0.00 0372852 53,118,326,838.73
09/12/16 06:39t52 RTGS#BANK 3ATENG 0.00 5,632,407,372.00 0369891 58,750,734,210.73
ROSIDA DIANA 330,000,000.00 0.00 0428052 58,420,734,210.73
09/12/16 ROSIDA DIANA 345,000,000.00 0.00 0428052 58,075,731,210.73
09/12/16 ROSIDA DIANA 300,000,D00.00 0.00 0428052 57,775,734,210.73
09/12/16 15:22,52 M GHUFRON VAWH 209,050,000.00 0.00 0928052 57,566,684,210.73
13/12/16 11:30:25 KWITANSI 1611001 ABC AMI PO H 16085 112,500,000.00 0.00 0428052 57,454,184,210.73
13/12/16 11:26t 53 M VAQIH GHUFRON 200,000,000.00 0.00 0428053 57,254,184,210.73
13/12/16 15:08:50 RTGS#BUD KABUPATEN CIREBON 0.00 8,954,888,680.00 0369891 66,209,072,890.73
14/12/16 08:53: 7 M VAQIH 61,000,000.00 0.00 0428052 66,148,072,890.73
14/12/16 10:30: 11 M VAQIH 158,000,000.00 0.00 0428052 65,990,072,890.73
14/12/16 10:30,45 M VAQIH 150,000,000.00 0.00 0428052 65,840,072,890.73
14/12/16 10:32:27 042801000335304-PT ANEKA MEDIKA INDO 0.00 429,787,153.00 1398051 66,269,860,043.73
14/12/16 14:16*. SPAN: 160141301017417000001 0.00 206,678,232.00 SPN410 66,476,538,275.73
i8 ’12/16 0428051 1101 CA Cash Deposit 0.00 75,845,144.00 0428051 66,552,383,419.73
10:43:47 MUCHAMAD GHUFRON VAQIH 300,000,000.00 0.00 0428051 66,252,383,419.73
16/12/16 10:23,:05 MUCHAMAD GHUFRON VAQIH 135,000,000.00 0.00 0428051 66,117,383,419.73
16/12/16 10:30:12 SPAN: 160141301017486000001 0.00 275,570,977.00 SPN410 66,392,954,396.73
16/12/16 10:30 'i6 1 SRT REF BANK B085KCXIVDJS122016 PT AMI 150,000.00 0.00 0928052 66,392,804,396.73
16/12/16 10:36:44 RTGS#INDOFARMA GLOBAL MEDIKA 0.00 13,287,975,000.00 0369891 79,680,779,396.73
16/12/16 11:51! 50 0428053 1101 CA Cash Deposit 0.00 75,845,144.00 0428053 79,756,624,540.73
16/12/16 16:55: 15 ROSIDA DIANA 376,973,971.00 0.00 0428051 79,379,650,569.73
19/12/16 09:27).28 SPAN: 161821301043441000001 0.00 18,459,824,109.00 SPN410 97,839,474,678.73
19/12/16 14:14:35 SPAN: 160141301017583000001 0.00 277,333,87fiL00 SPN410 98,116,808,553.73
19/12/16 14:31.10 3 BK BG N 6 CEK FEB SD DES 2015 PT AMI 900,000.00 0.00 0428052 98,115,908,553.73
19/12/16 14:42.08 RTGS Trf Ovb CA 400,000,000.00 0.00 0428053 97,715,908,553.73
19/12/16 19:36'09 LAS BG (Provisi) 04280117160000025 425,662.00 0.00 0428891 97,715,482,891.73
1 ' 97,715,355,193.73
20/12/16›! ’10:2T :0 2 LAS BG (Adm) 04280117160000025 127,698.00 0.00 0428891
20/12/16 LAS BG (Provisi) 04280117160000024 250,000.00 0.00 0428891 97,715,105,193.73
14:19.#3
20/12/16 14:19.44 LAS BG (Adm) 04280117160000024 33,000.00 0.00 0428891 97,715,072,193.73
20/12/16 14:22t: 15 BY SERVICING FEE BANK GARANSI PT AMI 16F,000.00 0.00 0428053 97,714,907,193.73
20/12/16
21/12/16 14:22:15
10:10:3’8 BY SERVICING FEE BANK GARANSI PT AMI 638,492.00 0.00 0428053 97,714,268,701.73
RS PARU DR ARIO WIRAWAN-BANK MANDIRI 0.00 108,950,900.00 BRI0372 97,823,219,601.73
20/12/16 17:44:18 1 dari 3
21/1?,’16 13:20:45 RTGS#KPKD KOTA ADMINISTRASI 0.00 8,927,646,819.00 0369891 106,750,866,420.73
JAKARTA
21/12/16 13:54:14 R.GRETA-BANK BNI 0.00 58,795,000.00 BRI0372 106,809,661,420.73
22/12/16 09:43:02 RTGS#BANK JATENG 0.00 2,112,878,800.00 0369891 108,922,540,220.73
22/12/16 12:S8:5 0 CA Cash Withdrawal 12,500,000.00 0.00 0428053 108,910,040,220.73
22/12/1614:05:ID REK KAS UMUM DAERAH KABMAGETAN-BANK 0.00 173,557,900.00 BRI0372 109,083,598,120.73
JATI
22/12/16 14:33:50 RTGS Trf Ovb CA 150,000,000.00 0.00 0428053 108,933,598,120.73
22/12/16 14:44:15 RTGS#R/P - TRANSFER/KU YAKIM I/IDR 0.00 9,822,182,385.00 0369891 118,755,780,505.73
22/12/16 14:58:£ 1 CA Cash Withdrawal 149,000,000.00 0.00 0428053 118,606,780,505.73
22/12/16 14:59:J.9 CA Cash Withdrawal 85,000,000.00 0.00 0428053 118,521,780,505.73
22/12/16 15:00;4 . CA Cash Withdrawal 500,000,000.0o 0.00 0428053 118,021,780,505.73
22/12/16 15:02:.2 CA Cash Withdrawal 310,000,000.00 0.00 0428053 117,711,780,505.73
22/12/16 15:03; 4 CA Cash Withdrawal 175,000,000.00 0.00 0428053 117,536,780,505.73
22/12/16 15:04:. 0 CA Cash Withdrawal 160,000,000.00 0.00 0428053 117,376,780,505.73
23/12/16 10:38:. 7 VAQIH 220,000,000.00 0.00 0428053 117,156,780,505.73
23/12/16 11:01:51 042801000335304-PT ANEKA MEDIKA INDO 0.00 429,789,153.00 1398051 117,586,569,658.73
23/12/16 13:01:E 2 UUN DWI UNTARI RS SOEBANDI-BANK JATIM 0.00 430,119,553.00 BRI0372 118,016,689,211.73
23/12/16 14:22:4 1 RTGS#SUMEDANG 0.00 8,351,158,181.00 0369891 126,367,847,392.73
23/12/16 14:25:5 6 RTGS Trf Ovb CA s0,000,000,000.00 0.00 0428052 76,367,847,392.73
23/12/16 14:32:1.1 ROSIDA DIANA 100,000,000.00 0.00 0428052 76,267,847,392.73
23/12/16 14:33:S 1 ROSIDA DIANA 600,000,000.00 0.00 0428052 75,667,847,392.73
23/12/16 RTGS#RSUD CHIK DITIRO 0.00 10,074,258,530.00 0369891 85,742,105,922.73
25/12/16 Bunga Rekening 0.00 102,535,880.00 85,844,641,802.73
2/16 23:59:5 Pajak 20,507,176.00 0.00 85,824,134,626.73
27/12/16 09:56: 0428051 1101 CA Cash a.00 75,845,149.00 0428051 85,899,979,770.73
27/12/16 10:14:0 Deposit RTGS Trf Ovb CA 300,000,000.00 0.00 0428051 85,599,979,770.73
27/12/16 10:14:1 RTGS Trf Ovb CA 256,760,000.00 0.00 0428051 85,343,219,770.73
27/12/16 10:27: RTGS Trf Ovb CA 57,166,586,273.00 0.00 0428051 28,176,633,497.73
27/12/16 14:15:1 KPKD KOTA ADM JAKARTA PUSAT-BANK 0.00 94,447,400.00 BRI0372 28,271,080,897.73
DKI
27/12/16 14:31:38 RTGS#BANK DKI 0.00 886,419,546.00 0369891 29,157,500,443.73
27/12/16 15:23:52 RTGS#SIDOAR3O 0.00 9,822,217,386.00 0369891 38,979,717,829.73
1 SRT REF BANK B086KCXIVDJS122016 PT AMI 150,000.00 0.00 0428052 38,979,567,829.73
R/P - TELLER GUBERNURAN-BANK 0.00 173,965,700.00 BRI0372 39,153,533,529.73
JATIM
28/12/16 10:04:16 M GHUFRON VAQIH 78,500,000.00 0.00 0428053 39,075,033,529.73
28/12/16 10:11:2# RTGS Trf Ovb CA 150,000,000.00 0.00 0428053 38,925,033,529.73
28/12/16 10:39:03 RTGS#RSUD DR.H.MARSIDI JUDONO 0.00 11,193,613,366.68 0369891 50,118,646,896.41
28/12/16 10:52:5!1 ATMLTRBCA 8495E 000006582 04280100033530 0.00 3,600,000.00 0888744 50,122,246,896.41
28/12/16 10:52:SQ RTGS Trf Ovb CA 1,663,490,400.00 0.00 0428053 48,458,756,496.41
28/12/16 10:53:SQ RTGS Trf Ovb 244,970,000.00 0.00 0428053 48,213,786,496.41
28/12/16 10:54:48 CA RTGS Trf Ovb 378,488,000.00 0.00 0428053 47,835,298,496.41
28/12/16 12:28:02 CA 0.00 654,545,455.00 0928891 48,489,843,951.41
MANDIRI BG EL 049726
’12/16 12:41:13 BEND RSU KOT TNG-BPD JABAR DAN 0.00 427,631,363.00 BRI0372 48,917,475,314.41
BANTEN
/12/16 14:35:3 RTGS#R/P — TRANSFER (KU YAKIM) 0.00 5,632,397,373.00 0369891 54,549,872,687.41
29/12/16 19:44:M BY 4 BUKU BG PT ANEKA MEDIKA 400,000.0D 0.00 0428053 54,549,472,687.41
29/12/16 19:59:C# INDONESIA 200,000.00 0.00 0428052 54,549,272,687.41
30/12/16 10:20:10 PMBUATAN 2 BUKU CEK PT AM1 40,000,000,000.00 0.00 0428052 14,549,272,687.41
30/12/16 10:38:46 RTGS Trf Ovb CA 940,500.00 0.00 0428891 14,548,332,187.41
30/12/16 10:38:4 » LAS BG (Provisi} 09280117160000026 564,300.00 0.00 0428891 14,547,767,887.41
30/12/16 10:41:4# LAS BG (Adm) 04280117160000026 2,484,488.00 0.00 0428891 14,545,283,399.41
30/12/16 10:41:44 LAS BG (Provisi) 04280117160000027 1,490,693.00 0.00 0428891 14,543,792,706.41
30/12/16 11:35:57 LAS BG (Adm) 04280117160000027 7,453,463.00 0.00 0428052 14,536,339,243.41
30/12/16 11:39:5 5 BY SERVICING FEE BANK GARANSI PT AMI 2,821,500.00 0.00 0428052 14,533,517,743.41
30/12/16 12:20:2 B BY SERVICING FEE BANK GARANSI PT AMI 0.00 600,000,000.00 0369891 15,133,517,743.41
RTGS#ZEUS VASCULAR PT
30/12/16 13:05:15 RSD MARDI WALUYO KOTA BLITAR-BANK 3ATIM 0.00 24,495,000.00 BRI0372 15,158,012,743.41
30/12/16 15:52:0 . RTG S#DPPKAD PROV KEP BABEL
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0.00 9,822,182,385.00 0369891 24,9 80,195,128.41
30/12/16 20:35:55 RSUD KOTA SEMARANG-BANK 0.00 426,001,000.00 BRI0372 25,406,196,128.41
JATENG
SaldoAwal Total Debit | Total Credit | Saldo Akhir
37,476,247,574.73 157,898,08R,405.OOH 1é5,828,032,958.68| 25,406,196,128.41
Terbilang :
DUA PULUH MMA MILYAR EMPAT RATUS ENAM JUTA SERATUS SEMBILAN PULUH ENAM RIBU SERATUS DUA PULUH

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