Employee Compensation Request Form

PT Mitsui Leasing Capital Indonesia

Date : 24 February 2014 Position : General Affairs Officer
Employee Name : Sofie Antikawati Employee Index Number (NIK) : 0196
Location : x Head Office
Branch Office

Compensation Purpose : x Marriage Passed away

Baby Birth Employee Spouse Children
Other
Date : 15 February 2014
Compensation Amount : Rp1,000,000
Remark : Married with Whywho

Attachment : copy of wedding invitation

Prepared by Reviewed by Approved by

HR *BM Joko Ariawan Kristian Ong

* Remark :
Sign
Employee Location
Prepared by Reviewed by Approved by
Head Office HR Staff - Head Office HR Unit Head HR Division Head
HR Staff - Branch Office & GM / AGM / Branch
Branch Office HR Division Head
CA Section Head (initials) Manager & HR Unit Head
 Employee Compensation Request Form
PT Mitsui Leasing Capital Indonesia
Date : Position :
Employee Name : Employee Index Number (NIK) :
Location : Head Office
Branch Office

Compensation Purpose : Marriage

Passed away
Employee Spouse Children

Baby Birth
1st child 2nd child 3rd child

Other
Date :
Compensation Amount :
Remark :

Attachment :

Prepared by Reviewed by Approved by

* Remark :
Sign
Employee Location
Prepared by Reviewed by Approved by
Head Office HR Staff - Head Office HR Unit Head HR Division Head
HR Staff - Branch Office & GM / AGM / Branch
Branch Office HR Division Head
CA Section Head (initials) Manager & HR Unit Head