FORM PENGAJUAN CUTI

Leave Application Form

A. Diisi oleh Karyawan (Fulfill By employee)

Yang Bertanda tangan di bawah ini (The Undersigned under this) :
N a m a (Name) :……………..…………………………………………..
Nomor Karyawan (Employee ID) : …………………………………………………………
Jabatan (Position) :……………..…………………………………………...
Departemen (Department) : ……………………………………………..………….
Tanggal Masuk (Join Date) : …………………………………………………………

Bermaksud untuk mengajukan cuti tahunan mulai : tgl ……./bulan ....../tahun ……

sampai/dan tgl ……/bulan ……/tahun……
Would like to propose annual leave starting at : date….../month….../year ………until/and
date…./Month…../year…..
Jumlah Hari (Number of Days) :………………. Hari (Days)

Karyawan (Employee) : Alasan (Reason) :

..
………………………………………………
_____________________ ………………………………………………
………………………………………………
Tanda Tangan Karyawan (Employee Sign)
B. Diisi oleh HRD Department (Fulfill By HRD Department)
Tahun Cuti Tahunan (Year of Annual Leave)
No Hal ( Items ) ……………….. < 2010
1 Jumlah Hari Hak Cuti (the right number of AL)
2 Cuti Yang Diajukan (proposed AL)
3 Cuti Khusus (Special Leave)
4 Cuti Tahun Lalu(AL Last Year )
5 Sisa Cuti Tahunan (Remaining AL)
Disetujui/Ditunda Dari (Approve/delay from*))
Tanggal (date) : ………………

Disetujui (Approve) HRD Dept. Mengetahui (Acknowledge)

Atasan Langsung(Superior)

______________ ______________ ______________

Leader HRD Manager Kepala Dept (Dept. Head)
Catatan (Note) :
1. The Annual Leave Application valid if signed by the authorized persons.
2. The number of leave calculated from the first day to last day of taken leave.
3. *) Strike trough the unnecessary.
4. AL: Annual Leave

F-HRM-018-1