Mouser Electronics, Inc.

P.O. Box 99319 Invoice - Credit Card Receipt

Fort Worth, TX 76199-0319
* Reference Number: 5A15E97 Invoice No. Invoice Date Page No.
52998335 26-JUN-19 1 of 1
Customer Service Rep: Internet Customer Service
Customer Service: +65 6788-9233
Purchase Order No. Master Tracker No.
Credit: +852 37564770
Federal ID# 61-1520598 INCOTERMS: FCA Shipping Point 16838752 1Z7759450418620418

Buyer Name Ship Via Customer No. Terms Order Date

EFRI SANDI UPS WW EXP SAVER 5A15E97 VI 2919 26-JUN-19

UNIVERSITAS NEGERI JAKARTA UNIVERSITAS NEGERI JAKARTA

Bill To ATTN: EFRI SANDI Ship To ATTN: EFRI SANDI
TEKNIK ELEKTRO, FAKULTAS TEKNIK UNJ TEKNIK ELEKTRO, FAKULTAS TEKNIK UNJ
JALAN RAWAMANGUN MUKA JAKARTA TIMUR JALAN RAWAMANGUN MUKA JAKARTA TIMUR
JAKARTA, 13220 JAKARTA, 13220
INDONESIA INDONESIA

Mouser Part Number

Line Customer/MFG Part No. Quantity Quantity Quantity Unit Price Extended Price
No. Description Ordered Shipped Pending (USD) (USD)
1 523-1521-60051 5 5 0 49.500 247.50
MFG Part No: 1521-60051
Amphenol / SV Microwave 2.92mm F Edge Launch / RF Connectors / Coaxial Connectors
US HTS:8536694010 ECCN:EAR99 COO:US

Merchandise Handling Freight TAX

Paid by credit card USD $272.50
247.50 0.00 25.00 0.00

Shipping Information
Ship Date: Jun 26, 2019
These items are controlled by the U.S. Government and authorized for export only to the country of ultimate destination for use by the ultimate
consignee or end-user(s) herein identified. They may not be resold, transferred, or otherwise disposed of, to any other country or to any person
other than the authorized ultimate consignee or end-user(s), either in their original form or after being incorporated into other items, without
first obtaining approval from the U.S. government or as otherwise authorized by U.S. law and regulations.

Tracking Number(s) and Billed Weights

1Z7759450418620418 0.25 lb

This order is subject to all terms and conditions displayed at: http://www.mouser.com/saleterms