BA. Pembayaran Hutang [PDF]

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BERITA ACARA PEMBAYARAN HUTANG Pada hari ini hari .......................................... tanggal ........................................ bulan .......................................... tahun ..............................................................................., yang bertanda tangan di bawah ini : 1.



Nama



: ......................................................................................................................................................



2.



Nama



: ......................................................................................................................................................



1. 2. 3. 4.



.......................................................................................................................................................................................................................... .......................................................................................................................................................................................................................... .......................................................................................................................................................................................................................... ..........................................................................................................................................................................................................................



Tempat/Tgl. Lahir Jenis Kelamin : Agama : Pekerjaan : Alamat :



: ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... Dalam hal ini bertindak untuk dan atas nama ......................................................................................................., yang untuk selanjutnya disebut PIHAK PERTAMA Tempat/Tgl. Lahir Jenis Kelamin : Agama : Pekerjaan : Alamat :



: ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... ...................................................................................................................................................... Dalam hal ini bertindak untuk dan atas nama ......................................................................................................., yang untuk selanjutnya disebut PIHAK KEDUA Dihadapan Allah SWT/Tuhan YME dan Para Saksi, telah dilakukan pembayaran Hutang atas nama : Nama : ...................................................................................................................................................... Tempat/Tgl. Lahir : ...................................................................................................................................................... Jenis Kelamin : ...................................................................................................................................................... Agama : ...................................................................................................................................................... Pekerjaan : ...................................................................................................................................................... Alamat : ...................................................................................................................................................... ...................................................................................................................................................... Yang menggunakan jaminan berupa : .................................................................................................................................. dan perjanjian ................................................................................................................................................................................. Pembayaran dilakukan oleh PIHAK PERTAMA yang terkait sebagai Ahli Waris atas jaminan tersebut kepada PIHAK KEDUA secara tunai sejumlah : Rp. .................................................................................... (............................................................................................................................................................................................................) yang merupakan jumlah total hutang atas perincian :



Demikian berita acara ini dibuat dengan sebenarnya, dalam kondisi Para Pihak sehat jasmani dan rohani serta tidak dalam tekanan pihak manapun, ditandatangani dihadapan Para Saksi diatas materai cukup di ....................................................................................... pada hari ................................................. tanggal .......................................... bulan .......................................... tahun ............................................................................... PIHAK PERTAMA,



PARA PIHAK



.................................................................. Saksi I,



..................................................................



PIHAK KEDUA,



.................................................................. Para Saksi



Saksi II,



..................................................................