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  • Surat Izin TGL 16 April SD 13 Mei 2022

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    SURAT IZIN TGL 16 APRIL SD 13 MEI 2022

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    15 views27 pages

    Surat Izin TGL 16 April SD 13 Mei 2022

    Uploaded by

    I R.7

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 27
    rd PT. Saipem Indonesia (Karimun Branch) FORM Rect Dae eT Cuti nah Anak kandung: 2 hae Savant LEAVE REQUEST FORM Tae RR OTE Employee Name sere yale | Badge 10 NWT - 000 183 | Position Pirernsn wilde | Dept/ereject PRODUCTION teave start oate [19 - Ly. [ teoveentone [22-4 -9092 | Nootows | S, ‘Type of Leave (Please check where appropriate) | onal ‘Baptism Leave: 2 days Cut tabunan Cu bapts 2 ha oft 7 Child Circumcision Leave: 2 days (oti penggantllembur (Gutivtanan 2 har | "Maing of mpioves Leave 3 dy ‘Compassonate Leave immediate Fara Catia 3 na Gut berka Klug int 2 hai | ‘Marriage of Daugther or Son Leave. 2days | | Compassionate Leave = Sibling: 1 day uti Bercuka - Saudara kandung 3 hari ‘Marriage of Sibling Leave: day Unpaid Leave (Cutinikah- Soudara kandung: har) “Cut yang tidak bay Paternity Leave: days | Sickteave {Cut ila tri dari karyowan melahirkan: 2 hari Cut sake Maternity Leave: 3 months ‘Other (Reasons) Leave uti karyawan perempuan melahickan:3 bulan I Cutilain F = [ame Foy | ‘eet wot - ples a Sup Serr Nout a lay 18-4- 9092 18-4- 9092 | 1€ Joy | r22- os cr PT Saipem indonesia Karimun Branch) FORM as si LEAVE REQUEST FORM aie employee Name: SYEFRIZAL ceseero + NTOOO307 Position FITTER, Dept./Project : Production teavestatonte | 30-04-9027 __| tenvetnaoate 07-05 or | no.ctoos | G DAT. ‘Type of Leave (Please check where appropriate) x | samalieme Baptism Leaver ati tahunan uti boptis: 2 har ‘Difindiew ‘hd Circumesion eave: 2 6a uti penggantlembur uti itanan: 2 hari ari joven taave: 3 da mpaisionate Leave «immediate f Ct lkahs 3 hari uti berdka -Kaluarga int: 2 har vi ther or Son Leave: ? days passionat ing Cutinkah - Anak kandung: 2 har ‘Cut berduka~Soudorakandung: 1 har) ‘Mawiage of Sibling eave: 1 day ‘Unpaid Leave ati mikah - Saudara kandung: thar uti yang tidak di bayar rity Leawe:? days Sidkleave uti ia str dari karyawan melahickan: 2 hari uti sat ‘Maternity Leave: 3 months ‘Other [Reasons] eave uti karyawan perempuan melahickan: 3 bulan Cutan AEMMARKS (yh Employee or Supers) (CUT! LEBARAN IDUL FITRI REMARKS (8y Haman Resource Department ‘Requested by: ‘Acknowledged by: | ‘Approved by: J__Empioyee Invpediate Supervisor ‘HR Manager i ishature Signature Signature SyEPRAL none = Nome 7 Name, - — Name [04 oore . 7 Date | Date Date. a Date ovis copes se comudered nono teva ns decuren sal be vied va OMS Shree fore se PT. Saipem Indonesia (Karimun Branch) FORM fae eS Leave Requr'st FORM aoa air cone SRN oes | Dept (Project. PRODUCTION tenesunone [30-0 Bone ‘ype of teave (Please check where appropriate) 27-05-2012, | NoofDavs / | somal pana | | Sota a om Cuts pengaant tem ize of fmployen Leave 3 d2y snpassonate Leave - immediate Famiy: 2 dave Cut kah 3 hae uti berduka -Keluarga inti: 2 har ‘Compassionate Leave. Sibling: day Gutiberdula-Sauearskandung: 1 har Unpaid Leave uti yang tidak el bayor ‘SiecLeawe ila ti dae Kaeyawan melahitkan: 2 hae Corisakit | ately Leave: 3 months ‘Other (Reasons) Leave uti karan perempuan melahirkan: 3 bulan | catia ‘Chl ircumeision Leaves? avs Curl thitanan: 2 hart __OWaRKs (oy Human Resource Department] Requestedbyy ~~) ~—~S~S*«nwedgebys | Tuthorined by - “pproved I Superwior ead of agar HR Manager Signature signatcre Fauzan- Name Name Kae i. — Ll oxte a ~ bate [ rc PT. Saipem indonesia (Karimun Branch) FORM. SO | sol LEAVE REQUEST FORM ae Ey [= waateearrrs Emsoveevame = ug HASAN assed Nt COLO naa Tiaeipce | oeecmies = _eRoDucTON tewetndone [4 May WR | wootons | 4 days iit eave stort date = |v, OL Type of Leave (Pease check where appropriate) uw Cut baptis: 2 hari Off.iniiew ‘Chie Creumeision Leave: 2 dave | Cut penggantilembur {ti ahtanan 2 ha | Mavcage oftmployoo ave 3 paiorat eave -inmedite Fah 2 da | Gat nkah: 3 har | uti berdoka-Keluarga inti: 2h | ‘Mavroge of Davather or Son Lav ‘Compassionate Leave = Sibling {Cut nkoh Anak Kandlung:2 ha | uti bereuta- Saudarakandung: 1 hai ‘Mavriage of Sibling Leave: 1 day Unpaid Leave | uti nkah - Saudara kandung: 1 hor Cutiyang tidak bayar | Paternity Leave? days SiekLave | | cutibil tdan Karyn melaitan:2 het Cut sat i ]) MatesnityLeave:3 month (Other (Reasons) Leave 7 | Cutikaryawan perempuan melahikan: 3 bulan Gatitain Adel Fite AEMARNS [8y Human Rezouice Department Requested by Reknowiedged by ‘Authorized bye Employee imguediatg Supervisor Heag of Department \ Signatre pate NuRHasani | Ww Ib _ Nome Name Nome | c é = 7 eS PT, Saipons fndonesie Karin Branch) | seove sion Dae [te e4> o—9.| « sot Lent ese hac preprint) vw “anual " oftiecien - ‘Child Circumcision leave: 2 days et pergean enbr Gian: |) wiaie stents na 3 Gemeinde Fay 2 |__| eattmatea hort Cat er en Pe ts ‘Mowing of Daunecor Sn eave: ava Somazsense Laie Shing dar Cu nko ana tanng: hat Coed» Suara ang 3 hae acing OFS {ut ia Saveaa anne: tha Cat yang ak bya aieminy eave days | Skea uta ist dan karyawan mela: 2 ha Cuts ‘Matera ave: de - = oti aryanan perempuan meahirta 3 butan [| euctin EMARE (Be Eng pecan EF Fbwly sak alin EAS (8 Hunan Reece Copan Requested by Ralnoweapea By Ruitorzed Baprowed oy Frppiove imei She ae Stor | daniel Ry 14 [47/22 “iia cr PT. Saipem Indonesia (Karimun Branch) FORM Eee io LEAVE REQUEST FORM ie EmployeeName | DEVI LESIADEs Badge (D ENAT-000 15 [ Position aloloy Dept/Project: PRODUCTION I LeavestertDate | (B-o4- 2022 teaverndoae | 19-04 — 2022 | No.otowys | Annual Leave ‘Baptism Leave: 2 days Cut tahuran Cutt bape 2 hart ‘ifindiew ide da uti pengganlembur ut Kitanan: 2 hae arciage of fmplovee Leave: 3d Compassionate Leave mm dave Gutirkah: Shan Cut berduka = Keluarga in 2 hah war or Son Leave? davs Jonate Leave Sibi Cut kan anak kandung: 2 han Cut berduka -Saudara kandung: 1 har ‘arsoge of Sibling Leave: day agai ea Cut ria Sauara kandung 1 hast Cut yong tidak boyar Paternity Leave: 2 dav Sick ieave Cut ia str dn karyawan melahirkan: 2 hari Cat sat ‘Maternity eave: 3 monthe ther feasons) eave Cut karyawan perempuan melahikan: 3 bulan Gut iain REMARKS (Hu Resource Departmen Requested by; — ‘dlnawledgedy: | Authorized by: ‘Approved by: Employee Higa of Depariment HA Manager Signature Signature Signature Devi Lesiaves Uabre a Name tame Name (6-04-2622 _ layler ate Date Date ‘Allpnited copes re cosered uncon nde vy fh documents be vers OMS Sareont before wie cm PT. Saipem Indonesia (Karimun Branch) FORM ea eer sl Leave REQUEST FORM a employee name: DIR) Fermanale sodge 0 Nit seo Position Fifer Dept/rojeet : PRODUCTION teovestntoate — | fy /oy (2022. [tenetndone | 20/oy/so22__| nootoan| > doy Type of Leave (lease check where appropriate) ‘Annual Leave ‘Baptism Leave; 2 days Catahunan ‘uti bap: 2 hat fini Chile Circumcision Leave: 2 days Cuts penggantlembur ut tana: 2 hari Martioge of fmployee Leave: 3cnvs cate Leave» mediate Fai {uti kah: 3 hae Gat erika -Kelvarga it 2 hat ‘Marriage of Daugther or Son Leave: 2-day mpassionate Leave - Sibling ‘cut nah - Anak kandung: 2 ha ut berduka = Saudara Kandung: thal ‘Marriage of Sibling Leave: 1.day ‘Unpaid Leave Cut nah - Saudara Kandungs 1 art Cat yong veak dtbayar sn a sickieave Citi bila sti dariaryawan meabikan: 2 hari Cus skit a r ‘Other Reasons} Leave a eee cua | oer | pulerg Tam C Yo BATAM ) Urasen —_pahrerga (foal REMARKS (By Human Resource Department) PAIS) \ beknoiedeed ye ‘oried bye ppaToM “Tnmedifte Sunensor Head of Derariment TR Manager T ~ Signature ‘Signature, [Signature - Hono (B85 oa Far domo = ee = om Bieter [1% cy-2092 . = = = sa PT. Saipem Indonesia (Karimun Branch) FORM [a armane (ee ane LEAVE REQUEST FORM | troieename —: TENAWE WiBoue | set Amar. Coe 359. Position foreman Venza Dept /Project PRODUCTION. Leave Start Date [19 - 04.2632 | eoetnsoue 27, OG 20% “Toe of Leave (Please check where appropriate) wootoars | 2 Day Cut penggantilembur [same Sapilm tne: 2a | Gatitahenan | Cut bap ha | oii } ‘hil Gncumcson Leaver ye (uti Britanan: 2 hai Marriage of Employee Lenve: 3 dave Cutis 3 han | Sompstsonsie teste immediate Fai Jag | Cut berduka-Kelunga inti: 2 hari of Daugther or Son Leave? da Cuti mika - Anak Kandung: 2 har Compassionate Leave Sibling: 1 day uti berdva - Sauearakandung thar) |_ Cun karyawan perempuan melahitkan:3 bulan Maing of big Lee: Ungad Cut ka Sauder tana: ha | Cutiyang tia Paternity enw: T Sickiene Cit bila tr da arewon means 2 har stoke Mateity Lene 3 nent | 77 csitesniene Cuttin ‘Authorized by: T | a mature ee Signature ~ Signature Z Fences Wubotve pene wie |__| . = . Oy - ee {604-292 6. 04-2022 oa zc PT. Salpem Indonesia (Karimun Branch) FORM Se Ec LEAVE REQUEST FORM, ea Employee Name Ahmad Salut Badge 1D MMT 00049.5 Poston ot (der ept/moje PRODUCTION KY ep f temestoate [9 F104 9 9. tewetndoate | /O-05- 99 | nootoon 19. bar Type of Leave (Please check where aparopriats) ‘onal eave ut tahuran Cut bap: 2a ‘tinea zi {uti penggantlembur Cut shitanan 2 ha Mariage of Employee anv 3 day mpaionate Leave ui kal 3 har Cu berdka~Keluarga i 2 hath ‘Mavige of Oaugther or Son Leave: 2 da ‘Compassionate eave Sibling: 1 day {ut ikah~Anakkandung: 2 har (Cut bed -Saudarakandung 1 har ‘Mariage of Sibling eave: 1 day ‘Unpaid eave Cut ka Saudara kang: 1 hal Cus yang iak bayor L- Paternity eve: 2d SickLeawe Cat bila tr dal aryowan melaitan: 2 hac Cuts [J etnerincteawe:3 months her Catifaryaan perempuan melaikan:3 buon cuttin Pulang leat PLA (pul FIT FT) REMARKS [oy Human Retorce Duper) ems : rao Rexel ence Tinie Super end of Cepainet nar ) Or |_ Ooh, signature Signature ‘Signature ‘Signature Alictad. Zales [{] ALONE MTree Any 4 CWI Ns fire i is faa Z- OF: -0 9 oh ~ oR og-2 1-08 9 | tL o4 a ‘ted ope areconicered uncon the vay th dbcsmert sha be veri SuePot Boe c PT. Saipom Indonesia (Karimun Branch) FORM aoe) — | | Tamia so LEAVE REQUEST FORM a Empowename = Jendaid) ABDILLAY sages NT 005 OF panes “BETTER Dest /Proiect PRODUCTION §— WG. Leave Start Date 28 /04/ 2022 | teove Ena Date Nowofoay | 12 HART ‘Type of Leave (Please check where appropriate) 7) Hasalienie ] Saptam Leave? dye Cutitahuran (ati bapts 2 han Coffins il Circumcision eave: 6 {uti penggantilembur Guu kitanan: 2 ha Marriage of Employee Leawe:3 dis zl Cuniikah: 3 hae ut Berta Keluarga nth: 2 har ‘Marriage of Daugther or Son eave: ? da Compusionate Leave Sibi Cat ikah- Anak kang 2 ha Cut Berks Sara tand Marriage of Sibling Leave: day Unga eave Cutinkah - Saudara kandung® 1 hark YW | catryane ask bayor atest Leave: ? days Sickeave Cut ilaitidarikaryawan melahirtan:2 hari Catisake ‘Maternity eave: 3 months ‘ter (Reasons Leave Cutitaryawan perempuan melaikan: 3 bulan Cat in Beanie aa eee cane end of eo ions Signature I Signature Signature Gonos awtuaipsenye nea) aN | ob (04 / 2022 |WWf4/rorr | vaya: Ome : = i or 4 SS tend SareM PT. Saipem Indonesia (Karimun Branch) FORM LEAVE REQUEST FORM Tex e FORUEHOTRDEE Tae Ral SHOR ERDE Employee Name AMANE- SWAY TO Badge 1D NMT 000 £84 Position : F)TTER Dept./Project. : PRODUCTION NNG Leave Start Date 24 4 oF /2022| Leave End Date = Oe ex no.etonvs 20 Daye Type of Leave (Please check where appropriate) | ‘Annual Leave | Baptism Leave: 2 days Cut tahunan uti baptis:2 hart ‘Oftinsti hild Ciccurscision Leaver 2 dy Cutt pengeantitembur uti khitanan: 2 hari riage of Empl days ‘Compassionate Leave - Immediate Family: 2 days Cuti riko: 3 hori {uti berduka -Keluarga inti 2 har ‘Marrlage of Oaugther or Son Leave: 2 da uti nikah- Anak kandung: 2 hae ‘Compassionate Leave Sibling: day uti berduka -Saudara kandung: 1 hart ‘Marriage of Sibling Leave: 1 dav CCutinikah - Soudara kandung: 1 hari uti yang udak 6 bayar Paternity Leave: 2 dave Sick Leave uti bila istri dari karyawan melahirkan: 2 hari Cutt sakit ‘Maternity Leave: 3 months ‘Other (Reasons) eave Cui karyewan perempuan melahirkan: 3 bulan Cut lain Mupik LEBARAWY CTAawa) REMARKS [by Human Resource Department) aieaate niagsaes aaa “aaa baa Tete Supersor eo of Depa Tn Manat BL. a a rr WAH foUONTO | Pymoce ia” Ww Name] Nome ame ___Name 0b /0¥ J 2022 vara ate _ Date _ _M ante copie are comidered uncooled and he vide fis docu she veri vis OMS shareoit bles se uti nah 3 hati rc PT. Salpm Ingonesia(Karimun Branch) FORM aa sa LEAVE REQUEST FORM seer Employeename —: EET Badge NiKT oposeo Poston Teruo ESF Dest/rcect PRODUCTION tenestnoate [30-64 . Dov | wainaone [OG sera | woctoms | G Ya Bex “ype of eave (lease check where aporoprots) Tanallene Boikmiens 2a eutsahoron Cot op a tina Chi creumetion ene ati pengzoembur Cusine 2h aiage of fmpoyee eave. 3 das ‘omgassonate Lene. mediate Foi. 245 uti Borda - Keluarga ints Zhan riage of ni ‘Compusionate leave Sibling: Ly Cut ah Anak kann 2 bar Cut betula Saucer kandung: ha ‘MaciageofSibing Leave: tay Unga eave Cut mah - Sadar and: har Cat yang ik Bayar Paternitteave: 2 dans Sickle Cut bits dar kanya motahirkan 2 hart Cat salt ‘Maternity leave: 3 months ‘ther asons] Leave uti karyawan petempuan melahirkan: 3 bulan Y | catitin Tarte Ware JW mobaren ” REMARKS (by Human Resource Dearimeat) “Rahored Apart ——— Head of Department HR Manager _ —_ OLATHE Pot du, - Name Name. sian = Oy — 2% — aie Baie PT. Saipem Indonesia (Karimun Branch) FORM LEAVE REQUEST FORM ee tmoovenane Ek. SUDARSOMO saae0 MMT 000 S6S— Position ELT Tecwnucenn Dept/Project ; PRODUCTION teavestar date | Zo—4- Jozp | beavetndoate |OY-OS-2022| No.otoays V2. ony ‘Type of Leave (Please check where appropriate) ‘Annual Leave Baptism Leave: 2 days uti tahunan Cut baptis: 2 Rar ‘ftindiew| Child Grcumcison Leave: 2 days uti penggantlembur uti kitanan:2 has uti nkah: 3 hae passion Famine uti berduka -Keluarga iti: 2 hath riage 0103 zi ‘Compassionate Leave Sibling: 1d Cutinkah- Anak kandung: 2 hari Cut berduka-Saudara kandung: 1 hac ‘Marriage of Sibling Leave: 1 day ‘Unpaid eave Cut nha -Saudara kandung hath Cut yang tidak bayar Paternity eave; 2 days Sick Leave uti Bila ist dar aryawan melahinkan: 2 hart Cat sat ‘Matecnity eave: 3 months her (Reasons) Leave uti karyawan perempuan melahirkan: 3 bulan uti lain « Fduuly toate ke UB ant 7 EMARKS (By Humon Resource Department) Authorised by: Tiead of Departmet HR Manager caear 20 prs BA a Wome B= 0 = 9a Baie FT. Salpem indonesia Kaimun Branch) FORM as Leave REQUEST FORM are Employee are -MUGIANTO sedge 0 cco alien ITER Detitcea 1 Potion veavestartoate — [?,0—OL— Lo LL] tenetnaoate | 0P- OF-2022] rootoas [SO PAYS Type of Leave Please check where appropriate) x | allen Baptiam Leave: 2 dave Cutitanunan Cut baptis: 2 hari ‘Oftinaie ‘hil Crcumeison Leaves? dy Cut penggantlembur Cut thitanan: Zhan ‘Mariage of fmploves Leave: 3 dave ‘Gompassionate Leave Immediate Fam? days Cus nia 3 hee (uti berduka- Keuacga int: 2 hari Marriage of Son Leaves? ‘Compassionate Leave Sibling: day Cut nia - Anak kandung: 2 hae Cut berduka~Saudarakandung: thar ‘Mariage of ibing Leave: 1 day Unpaid eave uti ka Soudarakandung: thar Cut yang tidak di bayar Paternity Leave: 2 days Sickteave uti bla ist dar karyawan melahickan: 2 har Cut sae ‘Maternity tgave: 3 months her (Reasons Leave uti karyawan perempuan melahirkan: 3 bulon Gat ain REMARKS ay the Employee or Superior) (CUT? LEBARAN IDUL FITAI AENAARNS (ny Human Resource Deparment) Tequesied by Teknowiodgedy Tuthored by Roprowed br Employee inmate Supervisor Head d Deparment HR Manager ignature | ‘Sfenature Signature ‘Mucianro aNoner Name Nome Name tame \Y fou % = eat Date Date, Date PT. Saipem indonesia (Karman Branch) FORM os LEAVE REQUEST FORM = Employee Name NASRUDIN sage 0 eTo00994 Peston FITTER Dept/Proje Production tewestan pare |Bg-94 - POI | ewe endoate OF- OF 22] wo-otoan | 5 DAK ‘Type of Leave Please check where appropriate) x. | aenualiease ‘Baptlm Leave: 2 davs uti tahunan uti boptis: 2 har ‘Ofinstien| ‘Ghilé Circumeison Leave: 2 day Cui penggant lembur Cui itanan: 2 hae ‘Mariage of Employee Leave: 3 ‘Somnssonate Leave immediate Family? davs Cut mikah: 3 hari uti bercuka-Keluaga int: 2 har Mati Son ‘Compassionate Leave Sibling: Lay Cutinikah Anak kandung: 2 hark Cut bercula - Saudara kandung: 1 hart Marriage of Sibling Leave: 1 ay ‘Unpaid Leave uti rikah -Saudara kandung: {hari ‘uti yang tidak a bayar Paternity Wave: 2 days SidcLeave uti ia ist dari karyawan melahickan: 2 hari Cuti sabe Matern ‘Other Reasons) Leave uti karyawan perempuan melahirkan: 3 bulan Catia REMARKS (y the Employee or Supervise) CUT! LEBARAN IDUL FITAI ENARKS (8 Human Resource Department) Requested by: ‘eknowiedged by: Impediate Supervisor ‘Authorized by: ‘Approved by: of Bepartment HR Manager Hes Signatie Sinatra wasruoin ANOREEF \ Name, —s Name ‘Name. Name A. 04- 2022 one Date ite ont rc PT. Saipem indonesia (Karlmun Branch) FORM = | . ac Saino [ LEAVE REQUEST FORM Bak a Wi TROOTE Employee tame = Ep) \RaspalSvpy. Badge 10 NOT put Le Peston Laren Dept/Peolet PRODUCTION [enesaiane” [39-4 2012 [wseowone [9-6-9920 | moo [Sp ‘Type of Leave (Please check where appropriate) T aiailiens - Benoa tcttehnan Eat apt tha oie |” chideicandion ens ng Ext pereananbur Eitan ha Mirigs ol tngiee ent idaa Comair eet edie FSU Catia Sha orders hat i acne father a Sonata conpaid ar Ect Anoandng Ector Souda. dng tha sige ting cv Lany nai Casta SavdaraKandng. had |_| civenetts bor Paternity Leave: 2 days ‘Sick Leave 7 |_Cuti bila iste dari karyawan melabickan: 2 hari Cuti sakit ote ee? mata ihe eee uti aryawan peremnvan melahiran: 3 bulan Catia | Aen era 2 UHAARKS (By Human Resource Depanrert) Rknouedged by ~aaaheried immediate Supeyizor Rooroved oy: eR Manager ‘Ainted copes ae conse cored ath aly of cuenta ve al po | PT. Saipem indonesia (Karlmun Branch) FORM Sane EASE al I Leave REQUEST FORM ee _ Employeetine > Sipaemare sadtelD ss AMT 000 SER Peston Filer . Dept/Prject + PRODUCTION tewestanone | 20-04 22 tewetndoate | OF 05 22. novotoos | 4. Days. Type of eave (Paste checkwher approprite) ‘Annual Leave | ‘Bagtsm Leaves? dae (otitahonan (Ctl Boptis: 2 hae ‘ftw ‘hid icumcision Lewes 3 days uti penggont lembut (uti Kitanans 2 hai “Mariage of Employee Leave: 3 days [Cut mkahs 3 nat ‘Compasor te ewe immediate Fam 2 dave uti berdut, Reluarga ints 2 hat ‘Maviage of Douzther or Son save 2 days (Cutiikah - Anak kandungs 2 hath ‘Compassionate Leave Siblings day uti berduta -Saudara ancng: thas Marriage of Sibi Lnave 1 dag Cuti nah ~Saudore kaneing: 1 hari opaid Leave Cutiyang lak Bayar uti axyawan perenpuan metahickan:3 Bulan Paternity Lamers 2 days sek eave [Gusta iste da karyawan melaickan: 2 har Cutisaln (Materity teaver months ‘Stee [Reasons Cutilain EMARKS (8 Hunan osoureeDepertmant) Authorized by; ean Aekaowledged Ronranedy elo “Te Ht itanaer sre Satara ——luie [ate 7} Name uti penggantllembur (ut khitanan:2 har c PT. Saipom Indonesia (Karimun Branch) FORM Ste renee Emoioyeenome FALE TAT ABI « Bedge io WMT oo0gsc Position EGU GactHAL | Dept./Praject PRODUCTION tewesianone — | /Ma/go0n J tenetnenate | Yel (9902 | Neetouve | Zy )oey "peo ave (eat check where apart) Pome Toatin com Zan utara Cutter li ‘Child Cireumeision Leave: 2 days ‘Mariage of Employee leave: 3 dare (Cut meah: 3 hari Compassionate leave -nmedi uti berduka -Keluarga Ini: 2 hack ‘Mai her ‘Sompassionate Leave - Sibling: 3 day {uti ka - Anak kandung: 2 hath uti berduka - Soudara Fandung: Na ‘Maurine of Sibiog eave: 3 day ‘Unpaid teave uti nikah »Saudarakandung: i hari Cut yang tidak a Bayar ‘Paternity eave: 2 days Sick Leave Cutibila ist dari acyawan metshitkan: hari Cut sot ity Lea he Cui karyawan perempuan melahickan: 3 bulan Leave VV | earn TAMIL arte EAO_WAUPAROK EMEARKS (By Human Resource Depart) Teqeaed a aaa Taare aaa z immedi Head of Deparment a anager Ca eh ~ Signature y Giver Creare Pag - he me IQ- 0% 9 _ Date a Date rc PT. Saipem Indonesia (Karimun Branch) FORM Reames si LEAVE REQUEST FORM ae Empoyeeame =: SUH AE TONO 2eo010 NMT 000. Sb¢ Position FITTER TUBING Dept Project PRODUCTION leave Start Date Of- O§-2022 | reavetnaoate | OF - OS - 2022) Noctoms | FP May h “ype of Leave (Pease checkwhere appropiate) ‘anvalicove co as VW | catitananan Citi bap: 2a {at pongantlembur Cai ana 2 hah Marriage of Employee Leave: 3 days i ~ uti nlats 3h Ci ber = Kelvarg it 2 hat ‘Maiage.oDausther a Son eve 2 dvs =i Cut nah - Anak kangung ha Cat berduka-Sadarakandung! 1 ar ‘Mariagcofsibng eave: day ‘nnidieave Gatah-Soudora fondu! tha City do bara ‘Pateenity Leaves 2-days Sick nave = atl tr darren mela: 2 hr cits Meni eaee3 month ‘the Reasons eave Cit taryawan perempuan mebaitan 3 buon tin * Fp Maer & 1D ubrpane 7 AES Human Resource Degree} = Requested: einowiedea ee a Employee ‘nme ‘Supervisor ev - “HR Manager a ‘Signature | Tr a | = Vp : Signature 7 Sut TOMO | MALEK BW Granger Ip- 24- 2022 |(@-o7- FH 1-04 ~ 92. Date Date Date te Date Sa PT. Salpem Indonesia (Karimun Branch) FORM ol LEAVE REQUEST FORM TTT Employeetame > Diky ANOISKA Saggei | NMTODOSSO Position “FoRMICLAN, Dept Project: PRODUCTION Leave Start Date Pros - 2022 teave End date | 4 - 9S - 2022 moot pays | Ly Pere ‘Type of Leave (Please check where appropriate) ‘anova Leave ‘Baptism Leaves 3 das Cutitahunan ‘cut apts: 2 hark ‘Ofte (hg Gruision Leave: 2 days uti penggant tomb (un sitanan: 2 hari Marriage of fing 7 ‘Compassionate Leave - mediate family: 2 das Cut niah: 3 har Cut bed Keluarga int: 2 har ‘Marriage of Daur or Son Leave: 2 loys ‘Compassionate Leave Sibling: 1 day Cutinikan- Arak kandung: 2 hart Cut bra -Saudarakandung: Shar ‘Matrage of Sibing Leave: 1 day ‘Und Leave uti nikah- Saudara kandung thar uti yang tidak Bayar Paternity ives? dav ‘SickLeave Cut la sda karyanan melikan: 2 har Cutisae ‘Maternity \eaver3 month ‘Other Reasons} Leave uti karyawan perempuan melahiran: 3 bulan | eit © They aten A EID MUBARAK REMARKS (By Human Resource Department [Reauested Roproved by Employee HR Manager “Signature: tees Signature ley ANDIsea ; ‘Name. I ‘Name 7 Name. (8- 05 - BOIL | (B- 2G -2% Z Date me Date Date = Ho PT. Saipem indonesia (Karimun Branch) FORM Sarr LEAVE REQUEST FORM sree CSET Employee Name eugyona ‘Badge ID MMT cD0CcF Peettion perritun + Dept./Project PRODUCTION Leave Start Date 2/05 Joe Leave Ené Date 4 Jas Pare | novctoays | 3 hari “Type of teave (Pease check where appropriate) ‘Annual Leave ‘Baptism Leave: 2 days v Cuti tahunan Cuti baptis: 2 herd {Cus perggantlembur Cantona: 2a rage of Emplayee leave: pai immediate Fame 2 dave Gutman: 3a. Cut Berka Keluarga it: 2 han “Marriage of Daugther or Son Leave: 2.days Compassionate Leave - Sibling: 1 day - atta Anak handing: 2 hae {ut bers «Sada andung ha ‘Marriage of Sibling Leave: 1 day Unpaid Leave | {ut a= Sauda kandung hae utiyang tid Bayar | Paternity eave: ? days Sickteave Cat bla tr dar karan melaian:2 hae Cutisakt ‘Maternity Leave: 3 months ther | av {at aryawan perempuan melaian: 3 bulan cuttin fanny . mater (iS mabearnbr ENARKS (Oy Human Resource Departement) Requested —Reknowiedged by Immediate Supervisor Employee J Head of Department Far Gosh | eucrewe * | Cacaerni preva PT. Salpem indonesia (Karimun Branch) FORM mS ever [tow ec sa LEAVE REQUEST FORM a tmaeetane + Her OR mee AMT OaECD Peston eenciad po Dept/Prjedt PRODUCTION eawsanone [02 -OF Jon, | tenwtraoae | 04-05 Jor_ | Nootows | 3 PBT “Type of Leave (Please check where approprate) uti nkah = ana kandung: 2 hari ‘aval eave Baptim Leave: 2 days Cus tahunan Cut apts: ha tine ie Crcumekion ut penggantlembur uti titanan: 2 har ‘Marriage of ployee Leave: 3 days ‘Compassionate Leave Immediate Fam 2 days Cat ikah: 3 har Cai Bera -Keluacga ints har ‘Martiage of Dausther or Son ean: 2 days Compassionate Leave Sibi: 1. dng uti berduka-Saudarakandung: hari Cutiaryawan perempuan melatiian: 3 bulan Cet nah Souda and a Cut yang abn ran sickiene Cate er tryenanmetaitan: 2h a ake neritcenec ais tes Resond eve UM | eatin “Fhouly Meren A Em MuBatak REMARKS (Oy Human Resource Department ‘einowiedged ‘Authored bys Immediate Supervisor “Head of Department Approved By: Sinatre fe = se | HerS LM SAcanee> Pasougie, _ = = = Ta (B- oS - fore (@ -0% ~2% W- 6 nt Date Bate LC bate bate ‘i pntedcopes ae ondeed encore ate ay hs cue sal be verdana cm | PT. Saipem indonesia (Karimun Branch) FORM Se Ne = LEAVE REQUEST FORM =. ee employee Name = Ew {0 duren Badge 1D SNOT Qosyy Position Teenivan CAT Dept./Project PRODUCTION / TORTUE PROJECT lenestrtonte [OG - OF - Jet | tenetndone | oY «es - Zeer] Novot Dov ¢ ber Type of Leave (Please check where appropriate) Cat penegantilembur Annual eave Baptism Leave: 2 days Gut tahunan Cut baptis: 2 har ‘ofintiew ig Creumeition Leave: 2 da uti Khitanan: 2 hari ‘Marriage of Employee Leave: 3 d2y Cutinikah: 3 har ‘Compassionate Leave - Immediate Family: 2 days Cut berduko-Keluarga int 2 hart Martioge of oF Son Lea Compassionate Leave - sibling: 1 da Cui nikah - Anak kandung: 2 hari Cut erika -Saudara kandung: 3 hart ‘Marsage of Sibing eave: 1 day “unpaid Leave (Cut rikah - Saudara kandung: 1 hari uti yang tidak 3 Bayar ‘eternity Leave: 2 days ‘Sick Leave uti bila istri dari karyawan melahirkan: 2 hari Cutt sakit | ‘Matecnty eave: 3 months Gat karyawan perempuan melahirkan: 3 bulan ‘Other (Reasons) Les [| eatin Hux ete REMARKS (y Human Resource Deparment) =e aaa ee tae = Se eee reer Co Slere(pe| a Dante, ptee 1B Grane, [sone — 18-04 Bom |p. by [eR 0 3 Date bate Date pate sae conde ucortrleané the vale ofthis document shalbe verted via DMS harePen beer se cc PT. Salem Indonesia (Karimun Branch) FORM ponaaienceen oa LEAVE REQUEST FORM SRST |_enoloeename C)PTO_PRANOTO sreeeio = VM 000 549 Position ELECTRICAL TECwIcIAN Dept./Project : PRODUCTION (Cut mkahs 3 hark teavesarone | OY-D5-2022 | wewetraone [O4- 05 -2620| Nooo | | “Type of Leave (Pease cheek where appropriate) ‘oaual eave optim eave 2 dvs V | catitahunan at bats 2 har offintow (Gil Grcumelion Lave: 2 das Cat perez tembur {altars 2a ‘Maine of Flore Lene: 3 ins ‘Compassionate eave Immediate Fail 2 das Cut berduka -Kelvarga it: 2 hai ‘Marisge of Dougther or Son Leave: 2 days Cui nikah- Anak kandung: 2 hath ‘Compassionate Leave Sibling 1 ay Gut berduka -Saudora kandung: 1 had Unpaid Leave Cut mika - Saudara kad hark ativan tidak bovar Paternity Leave: 2 days ick Len Cut bila it ar karyawan melahickan: 2 har Cutie ‘Maternity teaver 8 months ‘the Reasons) eave uti karyawan perempuan melahickan: 3 bulan catia thm Maire 2 EID taubareke ~ la Ke _Chcaente paces - Requested by: Aeknowlediged by ‘Ruthorzedby +] SC proved bys Empioyee Tnnmediate Sepervisor of Bepartpent—) Manager <. CIPTO PRANOTS | sigrature o (sinatare ‘Signature Name Nome, 1Y- 04-2022 | W- 64 -tt |M-oy—- 2 Baie bate Date Bae PT. Salpem indonosia (Karimun Branch) FORM. LEAVE REQUEST FORM edge 1 Employee ome + feos ROSAD : AMT. 000442.- Posten FIT. Dept/Prejeet + PRODUCTION Leave Start Date teawerdoae [OF- 05-92 | roctom |B Days uti baptis:? hai (Ghd Frcumeiion aver? days ‘Cui ehitanai 2 hi ‘Marriage of Employes Leave: 3 davs uti ikah:3 hart ‘Comorstionaty Leave: Immediate Fam: ti bord ~ lung ints 2 har ‘Marriage of Vaugthero¢ Sn Leave: 2 dave uti nikah «Anal kandung: 2 hart (Comonssiy te leave Sidings doy Cuti Berduta - Saudara and Lack uti nikah- Saudorakanaung’ 1 hae agai Lene Cuti yang tak haya Paterigy Leaves? days uti bist dar karyawran melahickan: 2 har Sekleve Gutisaee MNERIEueS nas ‘Other teas | | cutikaryawan perempuan melairkan: 3 bulan Cetiiain YAR [ty Numan Rose opainet) “Signature ~ Requested by: Roproved by: enplovee Hit isnager sel LEAVE REQUEST FORM aes Saege 0 + NNT. 000 442. Dept /Peoject PRODUCTION |_ Employee Name Postion temesanone [O4—O5 ~ 22. teavetnsoae | OF-0S-22 | woctoos |A pays || Type of Leave (lease check where appropriate) he | ese Baptism Leave: 2 days Cutitahunan, oo ‘Child Crcomelion Lene: 2 dows (Cat penggant lembur ‘Gui Rtanan: 2 ari ‘Marriage of Emolovec Leave; 3 dave ‘Compassionate igave-Immeriate Family: 2 days L Cut ikahs 3 hari uti berdu - Keluarga inti: 2 hari ‘Mawrlage of Daugtero Sn Leaves 9 days ‘Compassionate Leave Sibling: 1 day { uti mish» Anak kandung: 2 hart uti berdiua - Saudara kandung: thar Maage of Sibling Leaver doy apni Leave Cutindab-Saudaratondang: 3 har uti yang tidak dibayar 1 eaten Comer? dave — Yate util itr dar Karyawon melahiekan: 2 had uti sabi i [Maternity Leave 3 months ‘ier [econ Lene uti aryawan peconpuan melahikan: 3 balan Catia AeNWANNS (8 Human Hosource Departmen) Requested by: Relnowleaged by: Employes Tnmediate Supquisce Aparawd by: Ha Niamger "Se “efi ame lame a Name [seeies | Tan ene ae | ia | PT. Saipem Indonesia (Karimun Branch) FORM _ = easermaes = ee sf save REQUEST FoR a Employeename —: DETS. Teegeid TT. C0052.6 Postion : FiTTeR [ Benue + PRoDUCTION tnesanoue [4 -5-2OLL _| weetndoe | 75-2022 | Neola Y DAY | Type of Leave Please check where appropriate) Cut tabunan |_ Cut bapts: 2 hari | Offinaew |” Ghd cccomeision teaver days | uti penggantilembur Lol har | Marriage of Employee Leave: 3 dave Compassionate Leave - Immediate Family: 2davs || cutinitah: $ har | Cut beruka - Keluavga in 2a Matriage of Davatheror Son Leave: 2 days | | Compassionate Leave Sibling: Lday Cutt nikah = Anak kandng 2 hari |_ Gut ber dua ~Saudarakandung: thar | | ‘Mariage of Sibing Leave: 1 day | Unpaid Leave | Cutt nah - Saudara kandung: 3 hati | uni yang tidak di bayar | Paternity Leaves 2 day Sick Lene Cot bla ist dari karyawan melahirkan: 2 hal Cus soit | | ‘Maternity Leave: 3 months Other {Reasons} Leave “| uti karyowan perempuan melshirtan: 3 bulan Gatlin CuT\ LegaRAy REMARKS (By Human RecourceDepartinent) Requested by: Reknowledged by: ‘authorized Approved bye Employee Tramedjate Supervisor dof Depmytpent HR Manager Shpature (sianattve 7 1 |_-petns je eee

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