LAPORAN TRANSAKSI FINANSIAL

STATEMENT OF FINANCIAL TRANSACTION

Halaman 1 dari 4
Page 1 of 4

Tanggal Laporan : 13/05/24

Kepada Yth. / To : Statement Date

ILHAM NUGROHO Periode Transaksi : 01/04/24 - 30/04/24

Transaction Periode

TAMBAKSAWAH RT 5 RW 1 KEL TAMBAKSAWAH

KE,C WARU SIDOARJO,SIDOARJO WARU
SIDOARJO

No. Rekening : 316901049356530 Unit Kerja : UNIT WARU

Account No Business Unit

Nama Produk : SIMPEDES UMUM Alamat Unit Kerja : KANCA WARU

Product Name Business Unit Address KANWIL SURABAYA

Valuta : IDR
Currency

Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

02/04/24 01:39:15 BFST316901049356530SAINI :BNINIDJA 8888606 0.00 150,000.00 175,395.00

02/04/24 03:51:23 Top Up Shopee 0813xxxx367 zXXXXXXa via BRImo 8888583 101,000.00 0.00 74,395.00

02/04/24 06:24:00 Top Up Shopee 0813xxxx367 zXXXXXXa via BRImo 8888185 49,000.00 0.00 25,395.00

04/04/24 11:04:43 200001012_OB_1023026123365311 0371878 0.00 25,500.00 50,895.00

04/04/24 11:05:39 Top Up Gopay+62821xxxx799 via BRImo 8888208 1,000.00 0.00 49,895.00

04/04/24 11:05:39 Top Up Gopay+62821xxxx799 via BRImo 8888208 24,000.00 0.00 25,895.00

04/04/24 14:36:19 200001012_OB_1023034855556065 0371853 0.00 50,000.00 75,895.00

04/04/24 14:37:51 BFST316901049356530SAINI :BNINIDJA 8888612 0.00 100,000.00 175,895.00

04/04/24 14:37:54 601301221763603100161295 9942718 50,000.00 0.00 125,895.00

04/04/24 15:55:18 BFST1420018796812 NBMB:BMRIIDJA 8888342 2,500.00 0.00 123,395.00

04/04/24 15:55:18 BFST1420018796812 NBMB:BMRIIDJA 8888342 50,000.00 0.00 73,395.00

04/04/24 23:13:20 Top Up Shopee 0813xxxx367 zXXXXXXa via BRImo 8888350 48,000.00 0.00 25,395.00

06/04/24 23:52:59 5104811021802198#000000837658#ATM #TRFLA 0888923 0.00 2,750,000.00 2,775,395.00

07/04/24 00:10:16 BFST0885966018 NBMB:CENAIDJA 8888040 2,500.00 0.00 2,772,895.00

07/04/24 00:10:16 BFST0885966018 NBMB:CENAIDJA 8888040 50,000.00 0.00 2,722,895.00

07/04/24 00:32:40 Top Up Shopee 0821xxxx799 dXXXXXXXXXXy via 8888036 40,000.00 0.00 2,682,895.00
BRImo

07/04/24 01:36:12 Top Up DANA 0813xxxx677 HARXX DZU via BRImo 8888223 200,000.00 0.00 2,482,895.00

07/04/24 01:48:09 QRIS240985989247#9360000211499092437 0888406 24,400.00 0.00 2,458,495.00

07/04/24 01:55:45 Top Up Shopee 0821xxxx799 dXXXXXXXXXXy via 8888216 1,300,000.00 0.00 1,158,495.00
BRImo

05/13/2024 08:34:53
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 2 dari 4
Page 2 of 4
Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

07/04/24 01:58:45 BFST316901049356530Rumiyadi :APIDIDJ1 8888684 0.00 421,000.00 1,579,495.00

07/04/24 01:59:05 BRIVA8878803601039051NBMBILHAM NUGROHO 8888255 336,000.00 0.00 1,243,495.00

07/04/24 03:17:53 Top Up Gopay+62821xxxx799 via BRImo 8888136 1,000.00 0.00 1,242,495.00

07/04/24 03:17:53 Top Up Gopay+62821xxxx799 via BRImo 8888136 10,000.00 0.00 1,232,495.00

07/04/24 03:23:07 Top Up Gopay+62821xxxx799 via BRImo 8888399 1,000.00 0.00 1,231,495.00

07/04/24 03:23:07 Top Up Gopay+62821xxxx799 via BRImo 8888399 10,000.00 0.00 1,221,495.00

07/04/24 03:56:14 Top Up Gopay+62821xxxx799 via BRImo 8888578 1,000.00 0.00 1,220,495.00

07/04/24 03:56:14 Top Up Gopay+62821xxxx799 via BRImo 8888578 192,000.00 0.00 1,028,495.00

07/04/24 04:00:12 082139139799 00190610 000000007126 9942763 500,000.00 0.00 528,495.00

07/04/24 14:52:54 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888166 200,000.00 0.00 328,495.00

07/04/24 17:23:28 Transfer Ke TRIYONO via BRImo 8888119 30,000.00 0.00 298,495.00

08/04/24 04:43:19 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888222 250,000.00 0.00 48,495.00

09/04/24 22:41:47 Top Up Gopay+62821xxxx799 via BRImo 8888581 1,000.00 0.00 47,495.00

09/04/24 22:41:47 Top Up Gopay+62821xxxx799 via BRImo 8888581 22,000.00 0.00 25,495.00

10/04/24 05:18:13 BFST316901049356530SAINI :BNINIDJA 8888660 0.00 50,000.00 75,495.00

11/04/24 13:48:47 ts:1712818120210id:621598034241740800 0371877 0.00 600,000.00 675,495.00

11/04/24 15:38:28 Top Up DANA 0856xxxx458 DAVXX BAG via BRImo 8888377 50,000.00 0.00 625,495.00

11/04/24 16:34:45 Top Up DANA 0856xxxx458 DAVXX BAG via BRImo 8888475 50,000.00 0.00 575,495.00

11/04/24 16:42:40 Top Up DANA 0856xxxx458 DAVXX BAG via BRImo 8888330 50,000.00 0.00 525,495.00

11/04/24 17:00:42 Top Up DANA 0856xxxx458 DAVXX BAG via BRImo 8888410 50,000.00 0.00 475,495.00

11/04/24 17:18:00 Top Up DANA 0856xxxx458 DAVXX BAG via BRImo 8888528 50,000.00 0.00 425,495.00

13/04/24 22:44:30 082139139799 00190344 000000013797 9843918 400,000.00 0.00 25,495.00

14/04/24 13:10:37 BFST316901049356530SAINI :BNINIDJA 8888705 0.00 50,000.00 75,495.00

14/04/24 13:47:09 BFST316901049356530SAINI :BNINIDJA 8888649 0.00 50,000.00 125,495.00

14/04/24 14:37:16 Top Up Gopay+62821xxxx799 via BRImo 8888209 1,000.00 0.00 124,495.00

14/04/24 14:37:16 Top Up Gopay+62821xxxx799 via BRImo 8888209 99,000.00 0.00 25,495.00

16/04/24 00:00:00 Monthly Fee ATM 2,500.00 0.00 22,995.00

16/04/24 23:59:59 Admin Fee 5,500.00 0.00 17,495.00

21/04/24 13:38:39 BFST316901049356530SAINI :BNINIDJA 8888696 0.00 100,000.00 117,495.00

21/04/24 13:46:14 BFST316901049356530SAINI :BNINIDJA 8888633 0.00 60,000.00 177,495.00

21/04/24 13:46:47 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888236 100,000.00 0.00 77,495.00

05/13/2024 08:34:53
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Page 3 of 4
Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

21/04/24 19:13:38 BFST316901049356530WARSITO :BNINIDJA 8888608 0.00 50,000.00 127,495.00

21/04/24 19:21:57 Pembayaran Merchant ALFAMART U004 TAMBAK 0852991 54,800.00 0.00 72,695.00
REJO SDA via EDC 10478422

21/04/24 19:28:43 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888569 47,000.00 0.00 25,695.00

21/04/24 19:54:10 BFST316901049356530SAINI :BNINIDJA 8888663 0.00 60,000.00 85,695.00

21/04/24 19:55:30 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888015 20,000.00 0.00 65,695.00

21/04/24 22:27:52 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888414 40,000.00 0.00 25,695.00

23/04/24 08:23:20 BFST316901049356530SAINI :BNINIDJA 8888637 0.00 60,000.00 85,695.00

23/04/24 09:14:02 601301221763603100190610 9942763 50,000.00 0.00 35,695.00

23/04/24 09:33:41 BFST316901049356530SAINI :BNINIDJA 8888661 0.00 100,000.00 135,695.00

23/04/24 09:48:29 BFST1840421321 NBMB:CENAIDJA 8888025 2,500.00 0.00 133,195.00

23/04/24 09:48:29 BFST1840421321 NBMB:CENAIDJA 8888025 44,000.00 0.00 89,195.00

23/04/24 15:41:10 BFST1420018796812 NBMB:BMRIIDJA 8888586 2,500.00 0.00 86,695.00

23/04/24 15:41:10 BFST1420018796812 NBMB:BMRIIDJA 8888586 50,000.00 0.00 36,695.00

25/04/24 21:21:50 Transfer Dari ROBIT FUADI via BRImo 8888064 0.00 150,000.00 186,695.00

26/04/24 14:39:27 ATMLTRPRM B9501 000531617 31690104935653 0888213 0.00 500,000.00 686,695.00

26/04/24 14:50:56 BFST1420018796812 NBMB:BMRIIDJA 8888159 2,500.00 0.00 684,195.00

26/04/24 14:50:56 BFST1420018796812 NBMB:BMRIIDJA 8888159 100,000.00 0.00 584,195.00

27/04/24 14:59:17 Bayar QRIS 8888079 38,000.00 0.00 546,195.00

28/04/24 00:56:00 Top Up Gopay+62813xxxx367 via BRImo 8888281 1,000.00 0.00 545,195.00

28/04/24 00:56:00 Top Up Gopay+62813xxxx367 via BRImo 8888281 70,000.00 0.00 475,195.00

28/04/24 23:13:47 601301221763603100190610 9942763 100,000.00 0.00 375,195.00

29/04/24 08:12:50 Top Up DANA 0821xxxx799 ILHXX NUG via BRImo 8888545 50,000.00 0.00 325,195.00

29/04/24 18:06:03 601301221763603100570185 9942804 100,000.00 0.00 225,195.00

29/04/24 20:41:56 BFST316901049356530SAINI :BNINIDJA 8888611 0.00 200,000.00 425,195.00

29/04/24 20:56:04 601301221763603100440781 9942486 100,000.00 0.00 325,195.00

29/04/24 22:01:05 BFST1420018796812 NBMB:BMRIIDJA 8888079 2,500.00 0.00 322,695.00

29/04/24 22:01:05 BFST1420018796812 NBMB:BMRIIDJA 8888079 10,000.00 0.00 312,695.00

30/04/24 00:38:52 BRIVA1240807123343328NBMBIXXXXXXXXXXXO 8888091 48,850.00 0.00 263,845.00

30/04/24 21:39:46 Bayar QRIS 8888013 16,000.00 0.00 247,845.00

30/04/24 23:21:00 082139139799 00440781 000000030479 9942486 100,000.00 0.00 147,845.00

05/13/2024 08:34:53
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Page 4 of 4
Saldo Awal Total Transaksi Debet Total Transaksi Kredit Saldo Akhir
Opening Balance Total Debit Transaction Total Credit Transaction Closing Balance

25,395.00 5,404,050.00 5,526,500.00 147,845.00

Terbilang / In Words

SERATUS EMPAT PULUH TUJUH RIBU DELAPAN RATUS EMPAT PULUH LIMA RUPIAH
ONE HUNDRED FORTY SEVEN THOUSAND EIGHT HUNDRED FORTY FIVE RUPIAH
Biaya materai telah dibayar Lunas
Revenue Stamp Paid

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- In the case of any differences from your records, please contact us within not later than 14 days from the receipt of this Statement of Account
- Salinan rekening koran ini merupakan hasil cetakan komputer, tidak diperlukan tanda tangan pejabat Bank
- The copy of this Statement of Account is computer-generated, no official signature is required.
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- Should there be any change of email address, please notify the relevant Bank BRI Business Unit

05/13/2024 08:34:53