PT.

GPS FREIGHT SERVICES

LEAVE APPLICATION FORM
Please tick the type of leave applied for as appropriate.

[ V ] Annual [ ] Marriage

[ ] Advance [ ] Maternity

[ ] Compassionate [ ] National Service

[ ] No Pay Others (Specify): _____________

(A) To Be Completed by Applicant

Name DEDE BUDI Designation : Mr. Puneet

Department EXPORT DOCUMENT Entitlement 1 DAYS
FROM TO NO of DAYS (exclude rest days) Reason (s)
28 AUGUTS 2023 28 AUGUTS 2023 1 DAYS BACK TO HOMETOWN / FAMILY

Leave Balance Before THIS APPLICATION: 11 Days (b/f from last year + current year)
Leave Balance After THIS APPLICATION: 10 Days

Signature: Date: 25 AUGUST 2023

(B) To Be Completed By Immediate Supervisor

[ ] Approved [ ] Not Approved

Signature: Date:

(C) To Be Completed By Human Resorces Department

Leave Status certified correct: [ ] Yes [ ] No

Amendments to leave status, if any:

Posted in Leave Record Form: [ ] Yes [ ] No

Signature: Date:

NOTE:

Leave is granted on the understanding that should the applicant leaves the Company, he/she would
be required to reimburse the Company all leave taken in excess of entitlement.