KEMENTRIAN KEUANGAN R.I.

SURAT SETORAN PAJAK LEMBAR

DIREKTORAT JENDRAL PAJAK (SSP) Untuk Arsip Wajib Pa

NPWP :
Diisi sesuai dengan Nomor Pokok Wajib pajak yang dimiliki
NAMA WP : ............................................................................................................................................................................
ALAMAT WP : ............................................................................................................................................................................
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NOP :
Diisi sesuai dengan Nomor Wajib Pajak
ALAMAT OP : ...........................................................................................................................................................................
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Uraian Pembayaran: ....................................................................
Kode Akun Pajak Kode Jenis Setoran .................................... ............................................................
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Masa Pajak
Jan Feb Mar Apr Mei Jun Jul Ags Sep Okt Nov Des

Beri tanda silang (x) pada kolom bulan sesuai dengan pembayaran untuk masa yang berkenaan Diisi tahun teru

Nomor Ketetapan : / / / /

Diisi sesuai Nomor Ketetapan STP,SKPKB, SKPKBT

Jumlah Pembayaran : ..............................................................................................................
Terbilang : ...........................................................................................................................................................................
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Diterima oleh Kantor Penerima Pembayaran Wajib Pajak/Penyetor
Tanggal ........................, Tanggal..................
Cap dan tanda tangan Cap dan tanda tangan

Nama Jelas: ............................ Nama Jelas: ..............................

*Terima kasih telah membayar Pajak Untuk Pembangunan Bangsa*
Ruang Validasi Kantor Penerima Pembayaran

F.2.0.32.01
 1
tuk Arsip Wajib Pajak

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Tahun Pajak

Diisi tahun terutangnya Pajak

Diisi dengan rupiah penuh

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da tangan

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