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Hari : _______________________ Hari : _______________________

Tanggal : _______________________ Tanggal : _______________________


Departement : _________________________ Departement : _________________________

Nama : _________________________________ Uang Muka : _______________________ Nama : _________________________________ Uang Muka : _______________________

Jabatan : _________________________________ 1. Porter : _______________________ Jabatan : _________________________________ 1. Porter : _______________________

No. Polisi : _________________________________ 2. Tol : _______________________ No. Polisi : _________________________________ 2. Tol : _______________________

3. Parkir : _______________________ 3. Parkir : _______________________


Tugas : DELIVERY / PICK UP 4. Uang Jalan : _______________________ Tugas : DELIVERY / PICK UP 4. Uang Jalan : _______________________
Area / Route : _________________________________5. HIT/JET : _______________________ Area / Route : _________________________________ 5. HIT/JET : _______________________
KM Awal : _______________________________ KM Awal : _______________________________
KM Akhir : _______________________________ KM Akhir : _______________________________
Keterangan : _______________________________ Jumlah : _______________________ Keterangan : _______________________________ Jumlah : _______________________
_________________________________ Sisa : _______________________ _______________________________ Sisa : _______________________
_______________________________
_________________________________ _______________________________

_______________________________
_________________________________ _______________________________

__________________ __________________ __________________ __________________ __________________ __________________


Petugas Pemberi Tugas Kasir Petugas Pemberi Tugas Kasir

FORM NO : PCP/OPS-GOP/FORM/066 FORM NO : PCP/OPS-GOP/FORM/066


Rev. 02 Rev. 02
NB : Ditulis dengan HURUF BESAR, Tanda Tangan di tuliskan nama jelas. NB : Ditulis dengan HURUF BESAR, Tanda Tangan di tuliskan nama jelas.

Hari : _______________________ Hari : _______________________


Tanggal : _______________________ Tanggal : _______________________
Departement : _________________________ Departement : _________________________

Nama : _________________________________ Uang Muka : _______________________ Nama : _________________________________ Uang Muka : _______________________

Jabatan : _________________________________ 1. Porter : _______________________ Jabatan : _________________________________ 1. Porter : _______________________


No. Polisi : _________________________________ 2. Tol : _______________________ No. Polisi : _________________________________ 2. Tol : _______________________
3. Parkir : _______________________ 3. Parkir : _______________________
Tugas : DELIVERY / PICK UP 4. Uang Jalan : _______________________ Tugas : DELIVERY / PICK UP 4. Uang Jalan : _______________________
Area / Route : _________________________________5. HIT/JET : _______________________ Area / Route : _________________________________ 5. HIT/JET : _______________________

KM Awal : _______________________________ KM Awal : _______________________________

KM Akhir : _______________________________ KM Akhir : _______________________________

Keterangan : _______________________________ Jumlah : _______________________ Keterangan : _______________________________ Jumlah : _______________________


_______________________________ Sisa : _______________________ _______________________________ Sisa : _______________________
_______________________________ _______________________________
_______________________________ _______________________________

__________________ __________________ __________________ __________________ __________________ __________________


Petugas Pemberi Tugas Kasir Petugas Pemberi Tugas Kasir

FORM NO : PCP/OPS-GOP/FORM/066 FORM NO : PCP/OPS-GOP/FORM/066


Rev. 02 Rev. 02
NB : Ditulis dengan HURUF BESAR, Tanda Tangan di tuliskan nama jelas. NB : Ditulis dengan HURUF BESAR, Tanda Tangan di tuliskan nama jelas.

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