LEAVE APPLICATION

1. N A M E Muhammad Yazid
2 EMPL. NO. 932
3. DEPARTMENT/DIVISION Engineering LOCATION: Jakarta
4. POSITION TITLE Engineering Controller SA MA Team
5. DATE OF HIRING (as definitive employee) 17-May-18

6. ENTITLEMENT YEAR (To be completed by HR) ………………………………………………………..

7. TYPE OF LEAVE
a. Annual Leave ( Umroh ) ✘

b. Maternity / Marriage Leave

c. Unpaid Leave of Absence (Subject to Supervisor's approval)
d. Paid Leave (Manpower Law)
( ) Wife delivery baby ( ) Death of familiar member
( ) Marriage of employees' child ( ) Circumcision/Baptism ( ) Fullfill state obligation

e. Others: (Specification needed)

8. LEAVE RECORD (Applicable only for Annual Leave)

Has been taken ………………………………………...... : 2 working days

Balance recorded ………………………………………… : 10 1 working days
Intended Leave …………………………………………… : 8 working days
Balance of Leave ………………………………………… : 2 working days

9. PROPOSED LEAVE DATE RETURN TO WORK

FROM Month: May Date : 8 Year : 2019
TO Month: May Date : 17 Year : 2019 Date : May, 20th 2019
TOTAL WORKING DAYS 2 8 days
10. CONTACT ADDRESS IN JAKARTA OUTSIDE JAKARTA
& PHONE NUMBER
082176111474 +966564550656

APPROVED NOT APPROVED DATE: April, 23th 2018

11. SIGNATURES
Employee Manager Area VP Area Human Resources