PT.

SAMATOR TAIYO NIPPON SANSO INDONESIA

Cikarang, 29 Dec 2023

ANNUAL LEAVE FORM / FORM CUTI

To: Silvana Purnamasari

HR Dept.

Below is :
Name : Dian Ferdinan T
Position : Supervisor Engineer

With this letter would like to submit a letter of annual leave:

Date : 8,9,10,11,12,15,16,17,18,19,22,23 January 2023
Purpose : Family Gathering

Thus my letter of annual leave request. Thank you for your attention.

Approved, Petitioner,

( Silvana ) ( Direct Supervisor/Asst.Mgr ) ( Ferdinan )

Annual Left ( sisa cuti ) = 12 - 12 = 0

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 PT. SAMATOR TAIYO NIPPON SANSO INDONESIA

Employee Name ( requester ) : Dian Ferdinan Tampubolon

Acknowledge letter of leave :

( Hideki Kimura ) ( Kenji Sasaki )