A-03 Leave Application Form

LEAVE FORM

ID :

Name : Area :

Attendant Permit LEAVE

AL/ SUPERIOR
Date Day PR BT BTH MC CBA CKA CIM CKM CL CG CMA SL CTM CM UL LATE
SLO Approval Leave
14 12 ~ 2 2 1-Jan 90 45 1 3

16-Oct-18 Tue

17-Oct-18 Wed

18-Oct-18 Thu

19-Oct-18 Fri

20-Oct-18 Sat

21-Oct-18 Sun

22-Oct-18 Mon

23-Oct-18 Tue

24-Oct-18 Wed

25-Oct-18 Thu

26-Oct-18 Fri

27-Oct-18 Sat

28-Oct-18 Sun

29-Oct-18 Mon

30-Oct-18 Tue

31-Oct-18 Wed

1-Nov-18 Thu

2-Nov-18 Fri

3-Nov-18 Sat

4-Nov-18 Sun

5-Nov-18 Mon

6-Nov-18 Tue

7-Nov-18 Wed

8-Nov-18 Thu

9-Nov-18 Fri

10-Nov-18 Sat

11-Nov-18 Sun

12-Nov-18 Mon

13-Nov-18 Tue

14-Nov-18 Wed

15-Nov-18 Thu

Total Consume

Balance

Prepared by Approve End Of Month Acknowledged by

_______________ _______________ _______________

Employee Name Direct Superior HR

Date : _________ Date : _________ Date : _________

List of OSG Leave
POTONGAN/ Deduction

Memotong Fixed Meal, Marketing Available

No Type Symbol Name Max Cuti Income Attendant Example Duration
Tahunan Allowance Allowance Half-Day

1 Attendant A Absent -10 days Tidak Masuk Kerja tanpa alasan

Before 15th
NO YES YES YES Leave office without any notification
No

2 BT Business Trip 10 days Perjalanan Dinas Keluar Kota

Before 15th NO NO NO NO Domestic Business Trip

No

3 BTH Business Trip 10 days Perjalanan Dinas Keluar Negeri

International
Before 15th NO NO NO NO Oversease Business Trip
No

4 Permit MC Medical Certificate 10 days Sakit dengan bukti surat sakit Dokter.
YES YES
MC Half Before 15th
NO NO Sick leave with Doctor certificate evidence
YES
NO NO
5 Leave AL Annual Leave -10 days Cuti Tahunan, Sakit tanpa memberikan surat dokter, 12 Days /
Rencana kunjungan ke Dokter Year
Before 15th YES NO YES YES Annual leave, visit to doctor with plan.
YES

6 CBA Cuti Baptis Anak -10 days Membaptiskan Anak 2 Days

Before 15th NO NO YES YES Children Baptism

No

7 CKA Cuti Khitan Anak -10 days Mengkhitankan Anak 2 Days

Before 15th NO NO YES YES Children Circumcise

No

8 CIM Cuti Istri Melahirkan -10 days Istri Sah Melahirkan 2 Days
YES YES
CIM Half Before 15th
NO NO Wife Delivery baby
YES
NO NO
9 CG Cuti Keguguran Keguguran Kandungan 45 days

Before 15th NO NO YES YES Misscariage pregnancy

No

10 CKM Cuti Keluarga -10 days Cuti jika (Anak, Suami/Istri, Orang tua/Mertua) Meninggal 2 Days
Meninggal
CKM Half Before 15th NO NO YES YES Children, spouse, Parents & Parents in-laws Passed Away
YES

11 CL Cuti Melahirkan + 10 Days Cuti jika Karyawan wanita melahirkan 90 Days

(Karyawan)
Before 15th
NO NO YES YES Female Employee gave birth
No

12 CMA Cuti Anak Menikah + 10 Days Anak Kandung/ anak yang terikat dari pernikahan 2 Days
menikah
Before 15th NO NO YES YES Children/Children in-laws Marriage
No

13 SL Special Leave + 10 Days Ulang Tahun Karyawan Permanent 1 Days

(Birthday)
Before 15th NO NO YES YES Permanent Staff Birthday
No

14 SLO Emergensi/ Cuti 10 days Cuti dadakan dengan alasan yang bisa diterima Deduct from
Bersama YES YES perusahaan, dan Cuti bersama pemerintah AL (Annual
SLO Half Before 15th
NO NO Emergency leave & Collective AL
Leave) YES
NO NO
15 UL Unpaid Leave + 10 Days Cuti jika Jatah Cuti tahunan sudah Habis atau belum
YES YES mendapatkan Hak cuti tahunan bagi yang bekerja
UL Half Before 15th NO YES dibawah 1 tahunif : Balance AL is finish or not entilted AL yet YES
NO NO
16 CTM Cuti Tidak + 10 Days Cuti tidak memotong / Cuti pengganti
Memotong YES YES (ex: Khusus Replacement atau Company Holiday)
CTM Half Before 15th NO NO Leave not deduct to AL or replacement day
YES
NO NO
17 CM Cuti Menikah + 10 Days Karyawan menikah 3 Days

Before 15th NO NO YES YES Employee marriage

No

18 Late LT Terlambat / 15 Terlambat ≥ 15 minutes

menit
NO NO YES NO Late coming to office ≥ 15 minutes
No