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Invoice PT. CITRA WAHANA TIRTA INDONESIA trading as CARLSON WAGONLIT TRAVEL (62) 21-250 6650 Tax ID 01.909.618.9-058. 000 JL. JEND. SUDIRMAN KAV.26 JAKARTA 12920 INDONESIA Invoice No: Invoice Date: 02404566 21-Jan-13 Client No: Agent: SETIYO WIBOWO 0000161802 Booking Ref: JKPYQE Total (IDR) Taxes (IDR) Fare / Charges (IDR) Description VAT (IDR) WELLS/STUART JAMES MR 3,371,000.00 3,718,100.00 AIRBSP-DOM 126-2598128136 - 347,100.00 - GA 05-Nov-12 L 510 Mon, JAKARTA SOEKARNO BALIKPAPAN SEPINGAN - GA 07-Nov-12 L 519 Wed, BALIKPAPAN SEPINGAN JAKARTA SOEKARNO (168,550.00) (168,550.00) DISCOUNT -8790000000 - 0.00 450,000.00 454,500.00 TRANSACTION FEE -8800000000 4,500.00 0.00 72,440.00 72,440.00 MERCHANT FEE -MRF - 0.00 Total Taxes: Total VAT: 347,100.00 3,371,000.00 Total Fare/Charges: 4,500.00 Total Discount: (168,550.00) Total Merchant Fee: 72,440.00 Total Transcation Fee/Service Charges: 450,000.00 Total Charges : 4,076,490.00 Payments:Amount credited by CWT - Credit Card AXxxxxxxxxxxx3005 (4,076,490.00) (4,076,490.00) Total Payments: Total Invoice Due : 0.00 *No payment is required for this invoice* Please make cheque payable to PT Citra Wahana Tirta Indonesia or refer to the below for Bank transfer : PermataBank Tower I, 21st Floor Jl. Jend. Sudirman Kav.27 Jakarta 12920 3. Remittance to be made in the currency as stated. 2. Transfer/Cheque payable is net of any charges. 1. Exchange rate used as of date of payment/IATA. 4. Interest may be charged in the currency overdue a/c up to 2 percent per month. Account Name Bank Name for IDR Bank name for USD Bank Address 5. While making payment, please quote our invoice number. : PT CITRA WAHANA TIRTA INDONESIA : A/C PERMATA BANK NO. 701398254 : A/C PERMATA BANK NO. 1209004840 : BBBAIDJA : PT. Bank Permata TBK ("Permata Bank") Swift Code Page 1 of 1

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Page 1: 0 02404566 Invoice CrystalExport

InvoicePT. CITRA WAHANA TIRTA INDONESIA trading as

CARLSON WAGONLIT TRAVEL

(62) 21-250 6650

Tax ID 01.909.618.9-058. 000

JL. JEND. SUDIRMAN KAV.26 JAKARTA 12920 INDONESIA

Invoice No:

Invoice Date:

02404566

21-Jan-13

Client No:

Agent: SETIYO WIBOWO

0000161802

Booking Ref: JKPYQE

Total

(IDR)

Taxes

(IDR)

Fare / Charges

(IDR)

Description VAT

(IDR)

WELLS/STUART JAMES MR

3,371,000.00 3,718,100.00 AIRBSP-DOM 126-2598128136 - 347,100.00

- GA 05-Nov-12 L510 Mon, JAKARTA SOEKARNO BALIKPAPAN SEPINGAN

- GA 07-Nov-12 L519 Wed, BALIKPAPAN SEPINGAN JAKARTA SOEKARNO

(168,550.00) (168,550.00)DISCOUNT -8790000000 - 0.00

450,000.00 454,500.00 TRANSACTION FEE -8800000000 4,500.00 0.00

72,440.00 72,440.00 MERCHANT FEE -MRF - 0.00

Total Taxes:

Total VAT:

347,100.00

3,371,000.00 Total Fare/Charges:

4,500.00

Total Discount: (168,550.00)

Total Merchant Fee: 72,440.00

Total Transcation Fee/Service Charges: 450,000.00

Total Charges : 4,076,490.00

Payments:Amount credited by CWT - Credit Card AXxxxxxxxxxxx3005 (4,076,490.00)

(4,076,490.00)Total Payments:

Total Invoice Due : 0.00

*No payment is required for this invoice*

Please make cheque payable to PT Citra Wahana Tirta Indonesia or refer to the below for Bank transfer :

PermataBank Tower I, 21st Floor

Jl. Jend. Sudirman Kav.27 Jakarta 12920

3. Remittance to be made in the currency as stated.

2. Transfer/Cheque payable is net of any charges.

1. Exchange rate used as of date of payment/IATA.

4. Interest may be charged in the currency overdue a/c up to 2 percent per month.

Account Name

Bank Name for IDR

Bank name for USD

Bank Address 5. While making payment, please quote our invoice number.

: PT CITRA WAHANA TIRTA INDONESIA

: A/C PERMATA BANK NO. 701398254

: A/C PERMATA BANK NO. 1209004840

: BBBAIDJA

: PT. Bank Permata TBK ("Permata Bank")

Swift Code

Page 1 of 1

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