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Employee Data

Name : Mulia Azkaa Employment Status :


Payroll No. : Employment Date :
Department : Operations Working Location :
Cost Center : 23000000 Telephone Ext. No. :
LEAVE
Annual Leave Other Leave Reason :
Annual Leave Entitlement Year :
Annual Leave Days Requested : Leave Days Requested : ___ days
Effective Date From : Effective Date From : ___ / ___ / ___
And : Until : ___ / ___ / ___
I request to cash out : ___ days Remarks / Additional Note :
BUSINESS TRAVEL Have You Ever Taken Overseas Business Travel Before? Yes No
Business Travel Days Requested : ___ days
Effective Date From : ___ / ___ / ___ Previous Overseas Country :
Until : ___ / ___ / ___ Previous Overseas Business Travel Date From : ___ / ___ / ___
Business Travel Location : Overseas Domestic Until : ___ / ___ / ___
Business Travel Location Address :
Business Travel Purpose/Reason :
TRAINING Have You Ever Taken Overseas Training Before? Yes No
Training Days Requested : 1 days
Effective Date From : 15-Jul-2014 Previous Overseas Country :
Until : 15-Jul-2014 Previous Overseas Training Date From : ___ / ___ / ___
Training Location : Overseas Domestic Until : ___ / ___ / ___
Training Title :
Training Institution :
Training Objective :
Training Location Address :
Travel expenses to be reimbursed (for Domestic Business Travel & Training) : Actual Cost Lump-sum
NOTE: There is no lump-sum option if Business Travel or Training is conducted
MY CONTACT ADDRESS DURING LEAVE, BUSINESS TRAVEL & TRAINING:
Contact Address :
Telephone No.: 085715545323
ANNUAL
LEAVE
* For Business Travel and/or Training purposes: OTHER
when approved, one copy of this form should be sent to HR Relations (for Business Travel) LEAVE
or HR Planning & Development (for Training verification) and the original should be attached BUSINESS
to the expense report to Finance. For any advance fund request, one copy of this form should be TRAVEL
attached to the Advance Request Form. TRAINING
LeaveTravelTrainingForm.xls/Idr.
All higher management approval required (Supervisor/Manager/Vice President/President & Resident Manager) follows FAL regulation.
For HR & Administration Purpose
sign here:
when approved, this original form should be verified and sent to HR Relations.
* For Leave purpose:
NOTE:
sign here: sign here:
Cosmas Supriatna Mulia Azkaa Joko Mulyoko
JOTC
Jakarta Offshore Training Centre (JOTC) -DEPOK
(a) overseas (b) with company provided facilities (overseas & domestic). All expenses will be taken as actual cost.
Jl. Cempedak 2, blok C, No.74, Kel. Jatimulya, Kec.Tambun Selatan, Kab.Bekasi

Prepared by Approved by
3922

Sea Survival
LEAVE, BUSINESS TRAVEL & TRAINING APPLICATION FORM
Your Last Clothing Allowance Amount Taken :
Your Last Clothing Allowance Amount Taken :
Internship ( Mahasiswa KP)
Office/Offshore

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