PT.

RAVA ATHAYA
Site Office
Jl.Poros Trans Sulawesi
Desa Siumbatu, Kec. Bahodopi
Kab. Morowali
Prov. Sulawesi Tengah
RAVA ATHAYA www.ptravaathaya.co.id

LEAVE/FILED BREAK/PERMISSION APPLICATION

(PERMOHONAN CUTI/LIBUR LAPANGAN/IZIN)

Applican’s Name (Nama Pemohon) : MIR NO :

Position (Jabatan) : Department :
Point Of Hire (POH) : Effective :
Type Of Leavw/Field Break & Permission Applied (Jenis cuti/libur lapangan & Izin yang diminta) :
Field Break (Libur Lapangan) :
Annual Leave (Cuti Tahunan) :
Permission Or Sic (Izin atau Sakit) :
Reason (Alasan) :

PERIOD OF LEAVE/FIELD BREAK/PERMISSION (JANGKA WAKTU CUTI/LIBUR LAPANGAN/IZIN)

Star Date (Tanggal Mulai) :

End Date (Tanggal Akhir) :
Restart Date (Tanggal Kembali Kerja) :
Total Of Leave Day (Lama Libur/izin) :
_______________________________________________________________________________________________________
Transportation required (Transportasi yang diperlukan) Air Ticket Compensation (Kompensasi Tiket) ? Yes Or No
If Yes, Mention The Compensation route (Jika ya, jelaskan Rute Kompensasinta) :
Air Flight (Pesawat Udara) : 1.
Transportasi Darat : 2.
Transportasi Laut : 3.
Applicant (pemohon) Recommended by (Direkomendasi Approved By (Disetujui Oleh)
Oleh)

__________ _______________________ BAHRUL Z S

Employee Supervisor/superintendent SITE MANAGER
OFFICE USE ONLY / DI ISI OLEH BAGIAN HRD

Point & Date Of Hire : Job Pending Cheked By,

Last Field Break Schedule (Libur Terakhir) :
Date Due Schedule (Libur Tiba) :
Next F/Break Due Schedule (Libur berikutnya) : _______________ _______________
Last Dua Back To Site : _____ ____