FORM Doc.Number ABS.IV.

i/HR-016
SURAT TUGAS PERJALANAN DINAS Rev.No 01
(BUSINESS TRIP LETTER) Rev.Date 05.10.15

1. Nama / Name Cornelius Yanar Patih Krisnanda

2. Jabatan / Position Technical Services Executive

3. Dept./ Bag. / Department / Division Technical & Development Product

4. Tujuan Perjalanan / Destination Toll Jakarta Outer Ring Road S Lane A

5. Waktu Perjalanan s/d / Time Travelling until 1,4,6,7,9 Desember 2019

6. Alat Angkut / Transportation Kendaraan Operasional

7. Tujuan melakukan tugas perjalanan dinas / Purpose of conducting business trip

( ) Evaluasi proyek / Project Evaluation ( ) Tugas Marketing / Marketing Tasks
( ) Seminar / Seminar ( ) Tugas Belajar / Learning Tasks
( ) Tugas IS0 / ISO Tasks (v) Lain-lain, sebutkan / Others, mentioned Overlay witness

8. Penugasan menjadi beban / : Cornelius Yanar Patih Krisnanda

Assignment to be a burden

9. Jumlah orang yang ditugaskan / : 1 Orang / Person

Number of people were assigned

10. Keterangan tambahan / Additional : Witness Overlay Monitoring

information

11. Rencana biaya perjalanan dinas / 12. Realisasi Perjalanan dinas dari /
Plan of travel expenses Realization of business trip

a. Tiket / Ticket = a. Tiket / Ticket =

b. Airport Tax = b. Airport Tax =
c. Hotel & Cuci / Hotel & Laundry = c. Hotel & Cuci / Hotel & Laundry =
d. Makan / Meals = d. Makan / Meals =
e. Uang saku / pocket money = e. Uang saku / pocket money = Rp 675.000,00
f. Transport lokal / = f. Transport lokal / =
Local transportation Local transportation
g. Entertainment = g. Entertainment =

Jumlah / Total = Jumlah / Total = Rp 675.000,00

Diterima / Received =

Kurang/lebih / Less/More =

, Menyetujui / Mengetahui /
Approved Acknowledge
Pemberi Tugas / Penerima tugas / Pemberi tugas / Direktur / Director
Assignor Recipient of Duty Assignor

( Teguh Sudrajat ) ( Cornelius Yanar Patih

) K. ( Teguh Sudrajat) ) ( )