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LEAVE APPLICATION FORM

PERSONAL DETAILS
NAME POSITION : : Astri Mayasari Performance Analyst Engineer : Jln. Setiab !i II No "# Ja$arta Selatan

CONTACT ADDRESS CONTACT N%M&ER : EMAI. :

'(")*(+",--)(* A.Mayasari/0 a1ei.com

I 1is0 to a22ly for 3 !ays lea4e on May ""5"3t0 6 "7t0 "-,8 TYPE OF LEAVE

Emergency Ann al Maternity Ot0ers 92lease s2ecify:

Com2assionate St !y %n2ai!

REASONS/REMARKS Personal Matter ;acation<=oli!ay

St

!y

Marriage
(filled by HRD)

Ot0ers 92lease s2ecify: : ! e to nee!s to foc s on sc0e! le! legal family matters Ann al .ea4e &alance : >>. !ays &alance .ea4e after t0is a22lication : >>.

!ays Applicants signature; >>>>>>>>>>>>>>.>> Date : >>>>>>>>>... Line Manager

Receive !"; >>>>>>>>>>>>>>.>> Date : >>>>>>>>>... Pr#$ect Manager

A22ro4e!

Disa22ro4e

A22ro4e!

Disa22ro4e

>>>>>>>>>>>>>>.>> Date : >>>>>>>>>... Reason : >>>>>>>>>...

>>>>>>>>>>>>>>.>> Date : >>>>>>>>>... >>>>>>>>>... Reason

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