EMPLOYEE'S GATE PASS

Date: _____________ Type: (Please check) Official_____Personal ______ Undertime_____

Employee's Name Department Destination Purpose Signature

Immediate Supervisor's Approval: Human Resources' Approval

__________________________ __________________________
Signature over Printed Name Signature over Printed Name

To be accomplished by the Guard on duty:

Employee's Time Out: ______________ Employee's Time Back: ______________

__________________________ __________________________
Guard's Signature over Printed Name Guard's Signature over Printed Name