SURAT PENGANTAR TAGIHAN

No :

Kepada : ............................................................................

Dari : ............................................................................

Tagihan Mengenai : ............................................................................

............................................................................

............................................................................

Jumlah : ............................................................................

Terbilang : ............................................................................

............................................................................

Lampiran – lampiran : 1. Kwitansi Penagihan Bermaterai

2. Faktur Pajak Pertambahan Nilai

*) Coret yang tidak Perlu

Mohon pembayaran di transfer ke

Pemegang Rekening : ............................................................................

No. Rekening : ............................................................................

Nama Bank : ............................................................................

Ciamis, 2020

_________________