= | onal | PT. Salpem Indonesia (Karimun Branch) FORM LEAVE REQUEST FORM Employee Name: DARWIS PUTRA Badge 0 NwT000304 Position FITTER Dept/Projee + Production leavestartDate [4 MAY 2022 teave End pate |7 MAY 2022 No.of Dave [4 DAYS “Type of Leave (Pese check where appropriate) onus Leave ‘apt eaves 2 days X_| catitaninan uti baptis: ha ‘fio ld Csumeion ea Cun pengeantlerbur Cutt ttanan 2 har ‘Marra of Emglovee Leave: dave a i i ut ita 3 hae Cut becdka = Keluara int: 2 ha ‘Waring of Daughter or Son aves? ay ‘Sompassonate Leave Sig: day {Gu nitah- Arak anne 2 har Cut berdka ~Saudaraandung thar aciage of Sibling lenve 1 ‘Unpaid eve {Gut nkah -Saudarakandung: 1 hor {uti yang dba bayar Patent eave: 2 divs ‘sidcLeave Cat bits dari aryawan melsitan: 2 har Cats ‘Matern Leaves months ‘ibe (Reasons ee {uti taryawan pevempuan melahirkan: 3 bulan Cutten z REMARKS (0 te Employer Supervisor Hari Raya Idul Fitri 443 H WARES by Hunan Rowe Department) [__ Reknowiedged ys horned by Aeproved by [immediate Supenison” dof Department HR Morager | Serawe Sinaia Sonate 1 Sinature DARWIS PUTRA HAYSS NOVA TRoxks Tame Hane fame 5 Name 25 April 2022 25 April 2022 25 April 2022 Owe [easter oat = oa| rr ] PT. Saipem indonesia (Karimun Branch) FORM patina ese Saeuse sl | LEAVE REQUEST FORM —_ Employee Name | M |_Emooree Ficakal Sapra seen NMT_O00l07 Position (welder Dept /Project; PRODUCTION | tewesnoae — [4-6 - De ewerndome) | oice 2b | Naoto 4 par, | ‘Type of Leave (Please check where appropriate) | ‘Annual La, —— — ‘aplsm Leaves dave 1 uti tahunan Cuti baptis: 2 hari = 1 lites | Cl Gecmction ene? dv | Cat pengantembur | Catititanan:2hat | ‘Marriage of Employee Leave: 3 days | ‘Compassionate Leave - immediate Family: 2 days Gut ahha Cue Berd Kelvrg 2 hat Mage of Date orSon lense Dds Compassionate Leave Sing doy Cat nah Anak kang: ha Cut edt Sauder andang:1 has Mage of Sing ene: doy | Unpaid eve Cin nah Sauda tondung: that | Cit yang isk byer Paternity Leave: 2 daxs Sick Leave Ci ba tr dar karjevan ait: 2 ae Cust Maternity Leave: 3 months |” Other (Reasons) Leave Cut aryananpererpuanmelaian:3bulsn Gian \Ovue Fires Requestedby: Employee. ~ Ruthorized by: ‘Approved by: Headgf Deparement HR Manager —— W/o + talto [ou 2 bate |= Ea PT. Saipem indonesia (Karimun Branch) FORM | _Guti penggant lembur ae LEAVE REQUEST FORM SS enslorename + dois Simennduutia® Bade: pays COOLS Postion Wweleler Dept/Preject PRODUCTION leavestartdate | 16-Ow\-Dooe | tevetndote [16-04-9009 | Nocfoas| 1 Day ] annual eave ‘ontsm Leave: 2 caus NC | ont efaren uti baptis: 2 ha a | Offintieu — = ‘Child Circumcision Leave: 2 days Cut khitanan: 2 hart i je Leave: 3 days uti nikah: 3 har Compassionate Leave - immediate Family 2 dave Cut berduka -Keluarga inti: 2 hari Cutiikah- Anak kandung: 2 hart Cut berduka-Soudarakandung® 1 har ‘Mariage of Sibling Leave: 1 day. Unpaid Leave Cutinikah - Seudara kandang: hari uti yang tidak di bayar Paternity beaw sick Leave Cut bila sti dar karyawan melahirkan: 2 hart Cut sakit ‘Maternity Leave: months ‘Giher (Reasons) Leave Cutikaryawan peremouan melahirkan: 3 bulan Cut lain EMARKS (y Human Resource Department) Fray [Mea boo ee Taino a eae a Tired oetiee ead of Deparirent aR Marae ; S = Signature ‘Signature Signature «Signature | colli Smeswiat b-oncoreser eaeeees | me cI = 4-04-9692 [Ae 04- 2022 Baie Bate ae ‘lence copies reconsidered uncontoed ndthe valid ofthe document shale vce vi OMS Sharon etre uero PT. Saipem indonesia (Karimun Branch) FORM =a al | LEAVE REQUEST FORM eee Employee wae Suteey | eae Ung 000 FOR Poston Emer Deet/Pjeer PRODUCTION Leave Start Date 18-4 - 220. eave End Date No. of Days 10-4- 22 ‘ype of Leave (Please check where appropriate) unless Taian nat cuicemcen tian age of | yee Leave: 3 4 ‘Compassionate Leave - Immediate Famil an ai ne cereus ct | Marriage of Sibling Leave: 1 day ‘Unpaid Leave Paternity Leave: 2 dave T ‘Mateinity Leave: a months Cutikaryawan perempvan melahirkan:3 bulan Cation ‘Other Reasons) Leave REMARKS (8y Human Resource Department] —Famity Marten. C Teena tt ee. = eee a YY fez 4 ~Y- Pad 2 l= PT. Saipem Indonesia (Karimun Branch) FORM Se ae = LEAVE REQUEST FORM ers 2 Emporeenome : Patlindungan Siregar | ee MAT COSOF Postion : | oemtymojes enoouevon | ALG VTenesunone | (0 /oy 12022 | emeertone | 19 Jog] 2022| wacom | 1 Day “Type of Leave Please check where appropriate) ‘Annual Leave | |) Snot Leave: 2 dav | Guttanunan | Citibaptis: 2 har ftinieu | ‘Gls Greumeition Lave: ane | Cuti pengganti lembur I _ Cutt khitanan: 2 hari [ Marriage of Employee Leave: 3 days Compassionate Leave - Immediate Family: 2. | ita 3 at Cutbercuka = Kelrg in 2 ha ‘Marriage of Daugther or Son Leave: 2 days ‘Compassionate Leave - Sibling: 1 day. | Gat nikah=Anackandung: hai {itera Saudaratandung thar ‘Marriage of Sibling Leave: 1 day 1 Unpaid Leave | it ikah= Sauda tandng: 3 hac | _& | catiyang tidal bayar erly Leaves? da | Seckteave | Git bil tr dar karawanmelaitan:2 hae | Guttaet | ‘Maternity Leave: mont ‘ther eason Leave | Cui faryawan perenpuan melbrkan: 3 bul || eatin I i Js Sick Wit, Taken bh REMARKS y Human Resource Oepartmert) a aie amma — ae: hie Me LY Gera | AN : Signature ee ignature Signature as — ~ Signature prlusorger-$ | Salunto— Nisa | 2 | 19 Jo¢l pan | Y [ca] er 19/66 /2> te eT pas Ls Dated ae _Atpented cesar conte ncotced nh ty of hsocunart sulle ered MS Sarre lee wero PT. Saipem Indonesia (Karimun Branch) FORM Se | = LEAVE REQUEST FORM oe ee NPT 90039 pt fProject PRODUCTION | Dobro) Wwsr Pieeor temesonoue [ig 942022 | enetwone 19 oy -2orr] reot0m |Z Dery ‘Type of Leave (Please check where appropriate) | annwatteave ] Gaptiom Leave: Pays Cutitahuran | ut baptis:2 hai ] hil Gcumeision Leave: da uti penggantfembur | Cut thitanan: 2 har | | ‘Marrage of Employee eave3 dv Compasionate Leave i Catia an | Cut bert - Keluarga int: 2 hai ‘Macrnge of Daugther or Son Leave: ? dave ‘Compasionate Leave Sling: 1 day | ‘Cut nikah ~ Anak kandung: 2 hari uti berduka - Saudara kandung: 1 hari |” Mardage of Sibing Leave: 1 day 7) vaste ‘Cui nkah-Sausarakandung: 1 hari at yang tide bayar Paternity Leave: 2 days 1 “Sick Leave Cutis tid karyavan mela: 2 hae | Couisaet ‘Maternity Leave: 3 months | ‘Other (Reasons) Leave Cutt aryawen perempusn melahikan:3 bulan Catilin REMARKS (By Human Resource Department) 2 Urusein _k erearory ages ee Takara Tprovedby | oe pence Head ef epee ima | Jt ae _ Signature. __ Signatui Signature Sar eee Gam eS SEae eae ime ro [grey -2oze FTA me bee ute = =a ate| ro ] PT. Saipem indonesia (Karimun Branch) FORM =e =o Letve REQUEST FoRM | Mea G04 00 7 | teavestar dare | ZO [ tewesnsoare [02-05-2622 | wooroan | | ‘Type of Leave (Please check ‘Annual Leave ‘Gaptiam Leave: 2 days - Guttabunan - Gat apts: 2 hari Cutititanan: 2 hart ‘Compassionate Leow - mn doe Cut herd -Keluarga int 2 har Compassionate Leave Sibi t day Cut berduka- Saudaratandung: Lar ‘Unpaid Leave | ut yang tidak bayar | act aw SickLenwe yawan mebhickan: 2 hal Gaisakt ve 3 month ‘ther (Reasons) Leave Cut aryawan perempunn melahieaan: 3 bulan Catia ALHWANKS by Human Resource Department) — wowledgedby ‘Approved i ieee nikManags ‘Signature, “Signature ere ‘Signature fee | WAS@on. cr name ‘Name Name W-0F- Ve tl Woy -2 Date 7 Date —T Bate ate 3 ‘AM pntd ois are cored cote adh ty fh docaran sl vee a OME sha free,- PT. Saipem indonosia (Karimun Branch) FORM eo LEAVE REQUEST FORM a | Employee Name Su Hew Badge 10 hut 000 483 Postion Pare DeptProject : PRODUCTION | teavestartoate ~~ QOAR _ewetnd dae B~ 5 - BOLL wootoar | DAYS ‘Type of Leave (Please check where appropriate) ‘Annual Leave Saptism Leave: 2 days Catv tahunan Cutibaptis:2 har ‘often ‘Child Circumcision Leave: 2 dave | Cutipenggantilembur | Cutikhitanan: 2 hack ‘Marriage of fmployee Leave: 3 day ‘Compassionate Leave- Immediate Family: ? days | Cut nabs 3 har | Cutiberduka-Koluarga inti: 2 hae | [Mariage of Daugther or Son Leave: 2 days ‘Compassionate Leave Sling: day | ‘Cui nkah Anak Kandung: 2 hart Ctiberduka- Saudara kandung: 1h Marriage of Sibing Leave: day Unpaid Leave Cuti nah - Saudara kandung: UY | Catiyang tidak di bayar Paternity Leave: 2 dove Sek Leave ‘Cui ia st da karyawan melahrkan: 2 har Cutisaet Maternity Leave: 3 months ‘Other (Reasons Leave uti aryawan perempuan melahikan: 3 bulan Catitain EMMARNS [ay Human Aesoure Deparment] = Mudie (paren | t = a= Requested by ‘Approved by. HR Manager| Signature atePT. Saipem Indonesia (Karimun Branch) FORM LEAVE REQUEST FORM =a EmployeeName © JuLiAgry - ace 10 Ann oor 7 esition STeacRy Firren.. Sept/Poiect + POGTE Foearos 3 leavestartoate —|04". a - 9033 [ seme one 0G - os - gear No.of dar | 3 Oayr: | Type of Leave (Please check where appropriate) Y | cutizanunen Cut baptis: 2 hark iknow Chie Greumcision teaver? don {a penggntilembur {ai ean hari ‘Mavage of Employee Lene: days wnpesionoe Lane mediate Fa Cai 3 att Cut berduka- Kelurg int: 2 fa ‘Manage of Baugh or Son eave: 2 days ommssanate eave Sibi Cat ikah= Arak kandung: 2 ar Gut berka = Sauarakandung: 1 he ‘ariags of Sin osuid Leave {Gut sikah Souda andi! tha Cut yang dak bovar ateny amv? dave SekLenve {ut ia ist dart karyawan lain: 2 har Gasaut Moterity eave 3 month thes saxon Leave Ct karyawen perempuan melahirka: 3 ban Cain EMASKS ay the Emsloye or Suservior Leman ove pen: ENEARAS (By Human Resource Department) aay aaa aa Se aa as ae ba HN Joeaoy Car iting Name Name Name [9 o45m-| IF Oy. 200, i ‘lorie copereonsaeres ncnrledand he iy oft comer be werd va DMS Shae eee aePT. Saipem Indonesia (Karimun Branch) FORM Sane FORRES RTE = Ed LEAVE REQUEST FORM mae Empiveetone Depy pappigan bedee Ww (COE Peston rar [oemsroea + mooucron (Cara enc) tewestroae | 4 6S -29 teavetndoote | 7-95 <2 novotbos | A DAT pe of eave (lene check where appropiate ‘Annual Weave | Baptism Leave: 2 gaye VU | ecttahoran Gut bap han oftitew id reunion Lave: days Cuti penggantlembuc (Cutt Kritanan: 2 hal ‘Marriage of Employee Leave: 3 days {Cut nitahs 3 har Compassionate Leave - immedine Family. 2 days {Cut berduka~Kluargainti:2 hark ‘Mariage of Daugther or Son Leaves? days Cutinkah «Anak kandung 2 hati ‘Compassionate Leave sibling 1 day uti berduka- Saudara kandung 1 hari Cutt nth» Saudara kandung: {ak ‘Unpaid Leave uti yang tidak bayar uti karyawan perempusn melshirian: 3 bulsn Paternity Leave? days Sick Leave uti ia ist dar karyawan melahidan: 2 hark uti sake ‘Maternity Leave:3 months (ther (Reatons) Leave Cutifain ENCARKS (oy Putane KAmpure \sqri Tee ten Bieta _ ‘eknowiedged by Requested by: Employee ‘Approved ‘thorized by: z HR Manager Head of Departwent Immediate a Signature ~~ Signature “Signature BAUD WALID \3- 04-93 ‘led ope ae corse cone are yf cana shal be veri iO a bererc PT. Saipem Indonesia (Karimun Branch) FORM es seal LEAVE REQUEST FORM TeRTenamasT— Enoloreenome ADE pituawanay Sedgeios Amr OOO 4E4] Ee a Fran. Dept/Project : PRODUCTION Caran. GasCwer Leave Start Date OF-OF- 22. | beaver vate | O7— OF — 27. | no ctoaye <|_ 0A Type of Leave (Please check where appropriate) Annual eave nota Leaves dy Cut tahunan Gut bap: 2 ai Offinsieu ‘hil Creumcision eaves das E Cut pengant! lembur Cut ktanan: 2a > Mavioge of €mplovee eaves 3 dav smoassionate Leave Immediate Fai 5 Cutinikan: 3 ha uti berduka- Kuang it: 2 hak : stags of Daugther or Son Leave: 2 dvi passionate Leave - Sl ut nah Anak kandung: 2 hae Cut berduka- Saudarakandung 1 hal ‘Mattioge of Sibling Leave: 1 day Unpaid Leave Cut ka - Saudarakandung: 1 hari [L cuti yang tidak a bayar Paternity Leaves 2 days SicLeave uti bila ist dakaryawan meloiekan: 2 hak Gut sake ‘Maternity Leaver 3 months ‘her (Reasons Leave uti karyewan perempuan melahrkan: 3 bulan Gat ain ~= Letra Been ecvanca 0: RE lean Baw REMARKS (ay Hurnan Resource Department) Requested by ‘Acknowledged by: ‘Authored by: ‘Approved by: Employee 7) Immediate Supervisor J Hiead of Department HR Manager Haste Signature Name ‘ipa cone ae conieed uncon and the ay Me count halle veited is OMS Share in beer usPT. Saipem Indonesia (Karimun Branch) FORM == | 4 | ive | LEAVE REQUEST FORM | inorenione Ay. YuNULS — | secce AMT O00 hig Paton | owitied- _mobocnen “Type of Leave (Please check where appropra emer 2201 02. te) | Bostism Leave: day (Ci bapts: 2 har | teoeendone [3 = pret PAD | no.otoay | Offintey Cut penggantilembur Marriage of Employee Leave: 3 days uti nkahs 3 hari I Cut itanans2 hai | (hil Circumcision eave: 2 days ‘Compassionate Leave Immediate Family: 2 days (uti Borda - Kelarga ii: 2 har | Gotiikah Anak kandung: 2 hai |” Mariage of Daugther or Son Leave 2dnvg (Compassionate Leave Sibling: i day | Cutl berduka - Saudara kandung: 1 Cutiaryawan perempuan melahirkan: 3 bulan 1 | | Marriage of Sibling Leave: 1 day | cP tinaaid eave Cutinikah-Saudarskandking 3 hari uti yang tidak aya Paternity Leave: 2 dy | Sick eave oti ba st dari Kayan melahirkan: 2 hari | cori satt ‘Maternity Leave: § months ‘Other (Reasons) Leave | Cutan HAP pape _ipulgares Cay ageprttin) a IL — _ a oe = =o + = a a | ie a0 2 ee |Ss | = PT. Saipem indonesia (Karimun Branch) FORM aie LEAVE REQUEST FoRM Employee Name hutree | badge 0 | Poston Armee | pepe Project teweswrroate |B pe 2092. | seam indone | Fo tmei_Q0)3-| rostoms | He Hae ‘Type of Leave (Please check where appropra ‘Annual Leave | Baptism Leave: 2d i uti tahunan |. Cutibaptis: 2 hari ikinteu Cutipengganttembur Marriage of Employee Leave: 3 days {uti ikahs 3 hari | ‘Child Circumcision Leave: 2 days jate Family: day uti Berd -Keluarga ini: 2 har Mariage of Daugther or Son Leave 2 days Compassionate Leave «Sibling: t day uti berduka - Saudaratandung: 1 har Stat te [7 antes ing ave any TF tie : | | utintah-Saudorakandung ha |_eus yang tidak i boyor Paternity Leave: 2 days | ‘Sick Leave aan — oti dai aryauan melita: 2h | Geiser |) Maternity Leave: 3 month ‘Other Reasons) eave | |_exttaryawan ere meloikan: 3 blon | Carian — —SEMARHS (Sy Human Resouree Oeparment) | fs Reaves Aekqoniedged by Employee “meat Supervisor [signature Signaturenc PT. Saipem Indonesia (Karimun Branch) FORM ee wall | fneoe LEAVE REQUEST FORM f a Tee Re WoO é ime FERN JRWANDi |e | Position FITTER Dept./Project PRowcTteas [tewestntoae | 6, f= OS — DD. | tervetnsoue TO} = OS- 72. | Mootoar | A Days | ‘Type of Leave (Please check where appropriate) Co | poaatteaue — TT ante tenses ans | cat tahunan uti baptis: 2 hari — | - uti penggantilembur Cut kvtanans 2 hari | Compassionate leave - Immediate Family 2 days uti berduka-Keluarga int: 2 har ‘Martiage of Employes Leave 3 days Cut ia 3 ha Offin-tew |] Gh ercumeision eave: as | |” Mactiage of Caugther or Son leaves 2 days Compassionate Leave = Sibling: 3. day Cut rkah - Anak kandung: 2 hari uti berduka - Saudara kandung! 1 hart | Macrige of Sibling Leave: 1 day | Unpaid Leave | | _Cutinkah -Saudara kandune: 3 hari Cut yang dak boyar | Patemity Leave: 2.days |" Sick Leave | | cus bila ist dan karyawan melahirkan: 2 hari ut salt | | | other Bulan [cut ain AEHYARKS (By Human Resoure Deparment) ‘Acknowledged by: authorized Bye 7 ‘Approved by: Timmefate Superssar Head of Department HR Manager sana Tame Date Date i