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No. Revisi : 0.

0
No. Form : f12-010
Tanggal Berlaku : 12 April 2011

Annual Leave / Permit Form

Employee's name : M.AZIS Departement : APB


Branch : Back Office Annual leave available : day, year : 2014

Remarks Start date End date Total days Note


* Annual leave 28/3/2014 28/3/2014 1
* Permit
* Sick

Description :

Izin Karena Istri & Anak Sakit di Kampung

Requester : Manager Approval : HR Manager Approval :


Date : Date : Date :

(………………………) (………………………….) (………………………….)

Note : if sick more than 2 days, have to enclosed docter's reference


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No. Revisi : 0.0
No. Form : f12-010
Tanggal Berlaku : 12 April 2011

Annual Leave / Permit Form

Employee's name : Departement :


Branch : Annual leave available : 15 Day, Year : 2013

Remarks Start date End date Total days Note


* Annual leave
* Permit
* Sick

Description :

Requester : Manager Approval : HR Manager Approval :


Date : Date : Date :

(………………………) (………………………….) (………………………….)

Note : if sick more than 2 days, have to enclosed docter's reference


___________________________________________________________________
___________________________________________________________________
No. Revisi : 0.0
No. Form : f12-010
Tanggal Berlaku : 12 April 2011

Annual Leave / Permit Form

Employee's name : IMAM ISWANTO Departement : ACCOUNTING


Branch : Back Office Annual leave available : day, year : 2014

Remarks Start date End date Total days Note


* Annual leave 29-Sep-14 29-Sep-14 ½ Berobat
6-Oct-14 6-Oct-14 1 Panitia Kurban
* Permit
* Sick

Description :

TGL , 29 SEPT 2014 : BEROBAT NGURUT BADAN KRN JATUH

TGL , 06 OKT 2014 : JADI PANITIA QURBAN DI MAJELIS TALIM AT TAUBAH

Requester : Manager Approval : HR Manager Approval :


Date : Date : Date :

( IMAM ISWANTO ) ( KASWIARTI ) (………………………….)

Note : if sick more than 2 days, have to enclosed docter's reference


___________________________________________________________________
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