:
: Anggota Tim
2. N a m a
Jabatan
:
: Ketua Tim
terhadap
Nama
Jabatan
SK Kasir No/Tgl
: ..
: Kasir PT Graha Artha Nusantara
: ...............................................................
Pemeriksa I
(......................................................)
Kasir
(......................................................)
Anggota Tim
Pemeriksa II
(......................................................)
Manajer Keuangan
(......................................................)
Ketua Tim
x
x
x
x
x
x
x
x
Rp 100.000,00
Rp 50.000,00
Rp 20.000,00
Rp 10.000,00
Rp 5.000,00
Rp 1.000,00
Rp
500,00
Rp
100,00
=
=
=
=
=
=
=
=
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ....................
Uang Logam
............ keping
............ lembar
............ lembar
............ lembar
............ lembar
............ lembar
x
x
x
x
x
x
Rp
Rp
Rp
Rp
Rp
Rp
1.000,00
500,00
200,00
100,00
50,00
25,00
=
=
=
=
=
=
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ....................
Total uang rupiah ...... Rp ...................
Surat Berharga
1. Check BNI No...............tgl ....
2. Check BRI No............tgl .
3. Check BCA No............tgl
=
=
=
=
Rp ......................
Rp ...................
Rp ...................
Rp ...................
Rp ....................
Total hasil pemeriksaan kas .......... Rp ....................
Saldo menurut Buku Harian Kas .......... ....................
Selisih lebih (kurang) .......... Rp ....................
Penjelasan selisih:
............................................................................................................................
............................................................................................................................
Jakarta, ..............................................
Yang diperiksa
Pemeriksa I
(......................................................)
Kasir
(......................................................)
Anggota Tim
Pemeriksa II
(......................................................)
Manajer Keuangan
(......................................................)
Ketua Tim