www.ethiotelecom.et P.O.

Box 1047 Addis Ababa Ethiopia

tel.: +251 (0) 115 505
678 fax: +251 (0) 115
515 777
TRAVEL AUTORIZATION REQUEST
Requester Information
Departure Date ___________________ Ref.No. ( Work Order No.) ______________

Name

Employee ID:
Division
Position:
Job Level
Location Category
Specific Location
Signature:
Travel Information
Date From Date to
Site Specific Location Name of Location (DD MM YY) (DD MM YY)
Duty Station 1
Duty Station 2
Duty Station 3
Scope of Work (Mission of the
Travel)
Tools Description Vehicle Service Description
Type of Vehicle (Light,
Medium and Heavy)
Type of Tool Serial No./Plate No. Plate No.

Supported by: Immediate Supervisor ( Departure Date) Supported by: Immediate Supervisor (Arrival Date)

Name Name

Position: Position:

Signature: Signature:

Zone/Region Approved by Respective Zonal and Regional Managers ( Departure Date). Zone/Region Approved by Respective Zonal and Regional Managers (Arrival Date)

Name Name

Position: Position:

Signature: Signature: