Aer Thriveni Group, Indonesia LOCAL TRAVEL AUTHORIZATION FORM/ Travel ype/ Joss papel FORM PERSETUJUAN PERJALANAN LOCAL [erémergeney/ Dorurot C1 Normal Employee Name/ Employee ID/ ‘Grade/ Designation/ Department/ Nama Karyawan 1D Karyawan Level Jabatan Departemen \istah “ox to6ror | Sy | Meare rol plot ‘Mobile/ Gender! Age/ inet Advised By/ ‘Travel Mode/ Tipe Perjalanan Hand Phone Kelamin Unwr truksiPerjalanan oleh bus travels uM, Compan} faxi)/ Mobil (Pert yan oa Ge wk Oca tc ery /Sel / Mobil (Perusahaan/ Travel Purpose or Assignment/ Tujuan Perjalan atau Tugas D iner-Office/Site Visit; Antar Konlor/Proyek (1 Directors Visit/ Kunjungan Direktur CI Maintenance/ Perawatan (I Purchase/ Pembelian Ol Others (Specify)/ Lainnya (Detail) Origin/Destination | Onward/ om) fee Return/ | From/Dor Tel Re Ef Aso Tevon | Bordnerton [| Al, Jats owns alin Kembali Reon Aas © =| Departure/ Dare) | Tin Return/ Dotd/ Time? 5 =| Keborangkatan Terooo! | | Gy, |20 AMPH | Kombat Tanggal | —| Wale AM/Pm = =| Company Mess/ | Food/ Mokanan [1 Breck Fast/ Saropan C1 Lunch/ Makan Siang (I Diner/ Makan | Accommodation/ Akomodasi CI Required/ EZ=| Mess Perusahaan | Malam Requred/ Wilh U1 Food Not Required/ Makan fdok cpertkan Dibutuhkan (1 Not Requiced/Tidok dibuluhkan =| Local Advance Required/ k Previous Local Advance/ Pinjaman sebelumnya (I Setfled/ Selesai (21) Pinjaman untuk perjalaman Pe Gi Not Settled, Reason / Belum selesai, alasan a | Remarfs/ Keterangan fF En = % = #O0/je Hood Sone Site HR Officer Signature/ Site Finance Ofice Signature/ Employee Sifpbture/Tandatongan Kanyowan | _ Tana meni /Kepole Zore Tondolongon HR: Proyek “Tendotangon Firnce Proyek. Dale Tonggal Time/ Waly Date/Torggel | Tine) Watt Dato/Tanggal | Te/ Wako Date Tanggal Time/ Wekiu Aways submit Local Travel Claim Form on return fom the travl ta sotla the advance and claim tha expenses./ Slate mernasohan fen Maia Perjalean Lokal pade saat kembol deri perjlanan untuk manyelesaian pnjaman dan biaya tim LTA Form Version 1.0 Page I of