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SURAT PERMOHONAN IZIN KELUAR KANTOR SURAT PERMOHONAN IZIN KELUAR KANTOR

Yang bertanda tangan dibawah ini: Yang bertanda tangan dibawah ini:

Nama : ______________________________________________________________ Nama : ______________________________________________________________

NIP : ______________________________________________________________ NIP : ______________________________________________________________

Jabatan : ______________________________________________________________ Jabatan : ______________________________________________________________

Mengajukan izin / memberitahukan keluar kantor untuk keperluan: Mengajukan izin / memberitahukan keluar kantor untuk keperluan:
______________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________

Pukul : ___________________ s.d. ___________________ Pukul : ___________________ s.d. ___________________

Hari /tanggal : ______________________________________________ Hari /tanggal : ______________________________________________

Demikian, untuk diketahui. Demikian, untuk diketahui.

Tanjung Redeb, _____________________________________ 2018 Tanjung Redeb, _____________________________________ 2018

Mengetahui/Menyetujui, Hormat saya, Mengetahui/Menyetujui, Hormat saya,


Kepala Badan/Sekretaris/Kepala Kepala Badan/Sekretaris/Kepala
Bidang/Kasi/Kasubbag Bidang/Kasi/Kasubbag

____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________

NIP. ____________________________________________ NIP. ____________________________________________ NIP. ____________________________________________ NIP. ____________________________________________

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