PT IPC Terminal Petikemas No. Nota / Bill Number : 010.803.21-60.

011461
Kantor Pusat JL. Pasoso No. 1 Tanjung Priok, Jakarta Utara, 14310 Tanggal / Date : 22-FEB-21
Head Office
NPWP 03.276.307.0-093.000 Nota sebagai Faktur Pajak
Tax ID berdasarkan Peraturan Dirjen Pajak
PER-13/PJ/2019 tanggal 2 Juli 2019

NOTA PENJUALAN JASA KEPELABUHANAN

PORT SERVICE INVOICE

RECEIVING

Penerima Jasa / Customer

Nama / Name : PT. MITRA BANGUN SRIWIJAYA ABADI Nama Kapal / Voyage : MV LINTAS BRANTAS /
Nomor / Number : 15521883 07/21A/07/21B
Alamat / Address : JL. KELAPA GADING NO. 070 RT. 079 RW.024 Periode Kunjungan / Period : 2021/02/25 s/d 2021/02/25
NPWP / TIN : 82.753.038.7-307.000 No. Request / OL : A202102060146 / AOL1139723
Tgl. Request / Request Date : 22-FEB-21
Jenis Perdagangan / Type Of : MUAT/EXPORT
Trade

No Jenis Jasa Tgl Awal Tgl Akhir BOX Size Type STS HZ Hari Tarif Jumlah
No Service Type Start Date End Date BOX Size Type STS HZ Day Tariff Amount

1 PENUMPUKAN 22-FEB-21 26-FEB-21 18 20 DRY FCL N 1 25.000 IDR 450.000

MASA I
2 PASS TRUCK 18 20 DRY FCL 20.364 IDR 366.552
3 LIFT OFF 18 20 DRY FCL N 178.000 IDR 3.204.000

Administrasi / Administration IDR 57.000

DASAR PENGENAAN PAJAK / TAX BASE IDR 4.077.552
PPN 10% / VAT 10% IDR 407.755
Jumlah Tagihan / Bill Amount IDR 4.485.307

Terbilang : Empat Juta Empat Ratus Delapan Puluh Lima Ribu Tiga Ratus Tujuh Rupiah
Say Four Million Four Hundred Eighty Five Thousand Three Hundred Seven Rupiah

Ketentuan: Surat Edaran PT IPC Terminal Petikemas Nomor KU.301/6/9/1/IPC-TPK-19 Tanggal 6 September 2019.
1. Terhadap koreksi Nota Penumpukan dan Gerakan Receiving/Delivery hanya dapat diproses paling lambat 5 (hari) sejak tanggal cetak nota.
2. Terhadap koreksi Nota Realisasi Bongkar Muat (stevedoring) hanya dapat diproses paling lambat 5 (lima) hari setelah nota diterima pengguna jasa (tanggal salinan tanda terima nota).

Palembang, 22-FEB-21
PT IPC TERMINAL PETIKEMAS SENIOR MANAGER KEUANGAN

MARWAN HAKIM
NIPP. 285027353

IPC TPK Area Palembang

Jalan Mayor Memet Sastrawirya no 2 Boom Baru Palembang

010.803.21-60.011461 Print Date : 22-Feb-2021 18:27:48 | Page 1/2

 Lampiran Nota : 010.803.21-60.011461
No request : A202102060146

No No Container Size Type Status HZ

1 CMAU0454712 20 DRY FCL N
2 CMAU0648810 20 DRY FCL N
3 CMAU2158535 20 DRY FCL N
4 DFSU1574877 20 DRY FCL N
5 FCIU6224646 20 DRY FCL N
6 GESU1163440 20 DRY FCL N
7 GESU3405440 20 DRY FCL N
8 GLDU9892423 20 DRY FCL N
9 PHLU2100430 20 DRY FCL N
10 TCLU2286205 20 DRY FCL N
11 TCLU3970824 20 DRY FCL N
12 TCLU7461065 20 DRY FCL N
13 TEMU1262696 20 DRY FCL N
14 TGHU1374912 20 DRY FCL N
15 TLLU2795279 20 DRY FCL N
16 TRHU2126091 20 DRY FCL N
17 TRHU2306806 20 DRY FCL N
18 TTNU1171011 20 DRY FCL N

010.803.21-60.011461 Print Date : 22-Feb-2021 18:27:48 | Page 2/2

Powered by TCPDF (www.tcpdf.org)