SURAT JALAN

ASAL HASIL BUMI………………………... TUJUAN PENGIRIMAN……………………

DESA………………………………………... NAMA PENERIMA…………………………

KECAMATAN……………………………… ALAMAT PENERIMA ……………………..

KABUPATEN………………………………. ………………………………………………..

PROPINSI…………………………………… ………………………………………………..

NAMA PEMILIK.........................................................

ALAMAT PEMILIK.....................................................

TEMPAT MUAT..........................................................

JENIS ANGKUTAN.....................................................

NO. POLISI...................................................................

JENIS BARANG...........................................................

VOLUME BERAT........................................................

JUMLAH SAK..............................................................

KETERANGAN............................................................

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PEMILIK GULA,

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