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FM-PERS-028/Rev.

BUSINESS TRIP FORM


No. 03 / OTI / II / 2023

Undersigned state that :


Name Level
MUHAMMAD ALIN FITRIANTO Engineer

Destination Leaving on Return on Transportation by

ORIENT TECHNOLOGY PTE LTD 22/02/2023 24/02/2023 Ferry Vessel

Purpose 1 JIG, FIXTURES & MACHINE SETUP


2
3

Filled by person in-charge of destination place

Date
Name Remark Sign / Stamp
Arrive Leave

Notes 1 If anything happen along this trip please inform to :


PT. ORIENT TEKNOLOGI INDONESIA
Buana Central Park Fender No. 48, Batu Aji, Batam, Indonesia
Batam - Indonesia - 29439 TEL : 62-778-4090626
2 Thank you for your kind attention and cooperation.

Best regard,

AUTHORISED SIGNATURE

PT. SANNIN INDONESIA

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