PT.

SATAS TRANSPORTINDO INT’L

Komplek Perkantoran Pejaten Blok 5
Jl. Pejaten Raya Kav. 2 Jakarta Selatan 12510

LEAVE APPLICATION
Permohonan Cuti
Name :
Nama
Date of commencement :
Tanggal mulai bekerja
Type of leave :* Annual ( ) *Maternity ( ) *Big Leave ( )
Jenis Cuti Tahunan Melahirkan Cuti Besar
*Without Pay ( ) *Others ( )
Tanpa Bayar Lainnya
Date of leave : From To
Masa Cuti Dari Sampai
This leave entitled for the period of :
Hak cuti ini untuk masa kerja tahun: Tahun
Address of leave :
Alamat cuti :

FULLFILL BY PERSONNEL DEPT :

DIISI OLEH PERSONALIA
Leave entitlement / hak cuti : - days
Data absent / absen : - days
Absent with permit / izin : - days
Leave taken / cuti yg diambil sekarang : - days
Balance of leave : days

Aknowledge by, Approved by, Requested by,

……………… …………………. ……………….

Management head of department employee

To be fulfill by Management / head of department if leave postponed in order to avoid overdue

leave entitlement in due time. Diisi oleh Management / kepala bagian bila cuti ditangguhkan, untuk
menghindari hilangnya hak cuti karyawan bila jatuh tempo.
Reason : Signed by,
………….