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Annual Leave Form

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PT.

DIAN SANTOSA LOGISTICS

REQUEST FOR SICK LEAVE


Name : Date of Request
Nama Tanggal Permohonan
Position : Dept / Div
Jabatan Departemen
Date of Hire
Tanggal Masuk

Period of leave
Tanggal Cuti s/d

Reason for leave :


Alasan Cuti

Emergency Contact / Orang yang dihubungi dalam keadaan mendesak


Name
Nama
Address :
Alamat
Phone
Telpon

For Recorded in HRD Div.


year / tahun days / hari Catatan/ Remarks
Previous Balance / Sisa Cuti tahunan
Entitle Current Year / Hak cuti Tahun ini
Total / Jumlah
Leave Taken / Jumlah yang diambil
Balance of Leave / Sisa Cuti

Notes :
Catatan

Requested by, Recorded by, Approved / Disapproved by,

Signature of Applicant HRD Div. MANAGER

Hrd/Form/leav.xls

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