Spreadsheet: 2587e58d-b223-4dad-a0b7-8df680deb6f6
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | [NAME] ke-1 untuk : Wajib Pajak | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34 | Unnamed: 35
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Lembar ke-2 untuk : Kantor [NAME]
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Lembar ke-3 untuk : [NAME]
 |  |  |  | DEPARTEMEN [NAME] REPUBLIK INDONESIA
 |  |  |  | DIREKTORAT JENDERAL PAJAK
 |  |  |  | KANTOR PELAYANAN PAJAK
 |  |  |  | ……………………………………...………….  (1)
 |  |  |  |  |  |  | BUKTI PEMUNGUTAN PPh PASAL 22
 |  |  |  |  |  |  | (OLEH BADAN USAHA INDUSTRI/EKSPORTIR TERTENTU)
 |  |  |  |  |  |  | [NAME] : ……………………………………… (2)
N P W P |  |  |  |  |  |  |  |  |  | : |  |  | - |  |  |  | - |  |  |  | - |  | - |  |  |  | - |  |  |  | (3)
[NAME] |  |  |  |  |  |  |  |  |  | : | ………………………………………………………………………………
Alamat |  |  |  |  |  |  |  |  |  | : | ………………………………………………………………………………
No. |  | U r a i a n |  |  |  |  |  |  |  |  |  |  | Harga |  |  |  |  |  |  |  |  |  | Tarif |  |  | [NAME] dipungut
(1) |  | (2) |  |  |  |  |  |  |  |  |  |  | (3) |  |  |  |  |  |  |  |  |  | (4) |  |  | (5)
 |  | JENIS INDUSTRI : |  |  |  |  |  |  |  |  |  |  | Penjualan Bruto
1. |  | S e m e n |  |  |  |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
2. |  | K e r t a s |  |  |  |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
3. |  | B a j a |  |  |  |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
4. |  | O t o m o t i f |  |  |  |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
5. |  | …………………………….. |  |  |  |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
 |  | INDUSTRI/EKSPORTIR: |  |  |  |  |  |  |  |  |  |  | Pembelian Bruto:
6. |  | Sektor |  |  | …………………… |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
7. |  | Sektor |  |  | …………………… |  |  |  |  |  |  |  | Rp. …………….……………… |  |  |  |  |  |  |  |  |  | …... % |  |  | Rp. …………….………………
J U M L A H |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Rp. |  |  |  |  |  |  |  |  | ….…………………..…….
Terbilang : |  |  |  | …………………………………………………………………………………………………………………
Perhatian : |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | …………………., ……………………. 20 ……. (4)
1. | [NAME] PPh [NAME] 22 [NAME]
 | atas merupakan pembayaran dimuka |  |  |  |  |  |  |  |  |  |  |  |  |  |  | [NAME], (5)
 | atas PPh [NAME] tahun
 | pajak [NAME]. Simpanlah |  |  |  |  |  |  |  |  |  |  | NPWP |  |  | : |  |  | - |  |  |  | - |  |  |  | - |  | - |  |  |  | -
 | Bukti Pemungutan ini baik-baik untuk
 | [NAME] pajak |  |  |  |  |  |  |  |  |  |  | Nama |  |  | : | ………………………………………………………………………………………
 | dalam Surat Pemberitahuan (SPT)
 | Tahunan PPh.
2. | Bukti Pemungutan ini dianggap sah
 | apabila diisi dengan lengkap [NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Tanda tangan, [NAME]
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | ......................................................... (6)
F.1.1.33.04