LEAVE APPLICATION FORM

Addresed to Administration Departement

1. Date

: 10-Oct-09

2. Name

: WIDODO SAPUTRA

ID Number :

3. Departement

: PRODUCTION

Position

4. Leave Type

:
Annual

Sick

Maternity

Special

: SUPERVISOR
Not Paid
Leave

Emergency

5. Periode of leave
dd/mm/yy

dd/mm/yy

From Date 11/21/2009

Until Date

###

- SEMARANG -

MCT

Number of days

21 DAYS

Others/Remark

6. Reporting back from leave
7. Travel Sector

(Route)

MCT

Applicant 's Signature,

Taking over Task by,

Approved by,

Name : Widodo Saputra

Name : Pris F

Manager : Heri Atmoko

Comments

:

Administration Form
- Name
: Widodo Saputra
- Leave per

:

- Schedule

:

Part 1-Plan
'- Actual
Part 2-Plan
'- Actual
Part 3-Plan
'- Actual
- Last Joining

- Number
From

Until

8/29/2009

9/16/2009

Days
18

8/29/2009 10/11/2009

14

9/30/2009 10/16/2009

16

9/30/2009 10/16/2009
###

12/11/2009

16
21
21

###

12/11/2009

21

:

- Last Working Day
:
- Present request :
Prepared by,

- Hire Date

months
up to

days
- Number :
Date
Approved by,

Days

Moch. Khoirudin
HRD Departement

Ahmad Ghazali
Administration Mgr.

Heri Atmoko
General Manager

LEAVE APPLICATION FORM
Addresed to Administration Departement

1. Date

:

2. Name

:

ID Number :

3. Departement

:

Position

4. Leave Type

:
Annual

Sick

Maternity

Special

:
Not Paid
Leave

Emergency

5. Periode of leave
dd/mm/yy

dd/mm/yy

From Date

Number of days

Until Date

Others/Remark

6. Reporting back from leave
7. Travel Sector

(Route)

MCT

MCT

-

Applicant 's Signature,

Taking over Task by,

Approved by,

Name :

Name :

Manager :

Comments

:

Administration Form
- Name
:
- Leave per

:

- Schedule

:

- Hire Date
- Number
From

Until

Days

Part 1-Plan
'- Actual
Part 2-Plan
'- Actual
Part 3-Plan
'- Actual
- Last Joining

:

- Last Working Day
:
- Present request :
Prepared by,

months
up to

days
- Number :
Date
Approved by,

Days

Moch. Khoirudin
HRD Departement

Ahmad Ghazali
Administration Mgr.

Heri Atmoko
General Manager

Sampai di oman
Oktober

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Januari
Februari

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Cuti Pertama actual 20 hari
1 2 3 4 5 6 7 8 ###
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Maret

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April

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Mei

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Juni
Juli

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Cuti ke 2 actual 12 hari
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Agustus

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September 1 2 3 4 5 6 7 8 ###
9 ###
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Oktober

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Cuti ke 3 planning 14 hari
November 1 2 3 4 5 6 7 8 ###
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Desember 1 2 3 4 5 6 7 8 ###
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2007
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2008
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