Statement

The undersigned :

Name : rismanto

Positions. : board PT.GRAHA AYU KARSA

States that :

Name. : setyo wahyudi

Date of birth : madiun,28-12-1992

Address : village kranggan rt 14/06

Has ben,positively received and processed setyo wahyudi was like this brother has to pay the cost of which has been determined as follows:

Passport fee: USD 50

Medical fee. : USD 40

Id disnakertrans : USD 30

Departure fee : USD 2,250

If the job and visa down setyo wahyudi brother can not pay the fee,with forced me to cancel and imposed a fine of USD 417.thanks

Concerned ponorogo,28-12-1992

Board PT.GRAHA AYU KARSA

Setyo wahyudi. Rismanto