Nomor :

LEMBAR IZIN TAMU

....

1. Nama : ...........................................................................................................
2. Pekerjaan : ...........................................................................................................
3. Alamat : ...........................................................................................................
4. Nomor HP : ...........................................................................................................
5. Ingin Bertemu Dengan : ...........................................................................................................
6. Perihal : ...........................................................................................................

Pekanbaru, 2021

Paraf Petugas Security Tanda tangan tamu

( ........................................... ) ( ................................................. )

Catatan : KTP harap di perlihatkan kepada security dan ditinggal di pos selama berada
di lingkungan Kantor