PT.

Digital Media Kreatif ( IdBlog Network ) Travel Authorization Request Form Must be Submitted at least 7 days prior to travel Name Purpose of Travel Destination Length of Travel Date of Travel This Travel a personal trip From Cash Advance for travel is requested over the amount of Travel Sponsors by Third Party Yes If Yes, Who is the sponsor Method of Travel Air Sea Rail Land Private Vehicle Class Until Rp No in Cash Transfer to Account Email Position Department Job Duties Delegated to Cost Estimate
Transportation Lodging Expenses

Bus

Rental Vehicle
The particular benefit to the institute of using a private vehicle is accepted for this travel ( must be approved in advance ) The use of a private vehicle is of on particular benefit to the institute. IBN will not accept any liability for material damage which may arise from use of a private vehicle on institute business

* Reasons

Date, Place Authorized Official - Date and initials 1. Travel Authorized by 2 of Directors and Commisoners

Traveler's Signature

2. Approved Not Approved Reason as Applied with the following alterations 3. Officer approving payment: We do NOT consider the use of private vehicle as beneficial to the institute travel benefits the company but is funded or sponsored by a third party

Department

es Delegated to

Transfer to Account

vehicle is of on particular te. IBN will not accept aterial damage which se of a private vehicle ess

Signature