Kepada Yth :
.............................................
.............................................
Nomor Polisi :
No Jenis Mobil Waktu Sewa Keterangan Total harga
Catt :
□ Bensin, Tol, Parkir, ditanggung Penyewa Down Payment
□ Overtime Rp....................../Jam Balance
□ Uang Makan Sopir Rp.......................... Overtime
□ ......................................................................... Total
Pemilik Rental,
(Qadri)