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Sample Form Cuti

This 3 sentence summary provides the key details from the leave application form document: The document is a leave application form requesting annual leave, marriage leave, maternal leave, or other types of leave from [Date] to [Date] for a total of [Number] days, and includes sections for the applicant's details, purpose and period of leave, duties to be covered, remaining leave entitlement, and approval signatures.

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abi789ok
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50 views

Sample Form Cuti

This 3 sentence summary provides the key details from the leave application form document: The document is a leave application form requesting annual leave, marriage leave, maternal leave, or other types of leave from [Date] to [Date] for a total of [Number] days, and includes sections for the applicant's details, purpose and period of leave, duties to be covered, remaining leave entitlement, and approval signatures.

Uploaded by

abi789ok
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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PT. ..........

Form leave - 01 / Revisi 2011

LEAVE APPLICATION
Name Dept. Position Entry Date
: : : :

Address
(at which you can be reached during leave)

Phone No.

I. Type of leave requested


Annual leave Marriage Leave Maternal Leave (please attach the certificate from physycian or hospital ) Others

II. The Purpose of Leave

III. During leave, daily duties to be performed by :


Name Position : :

IV. Period Of Leave Request


Starting from (date) Until (date) Number of leave day (s) Note : : : :

Remaining Leave Entitlement (to be filled in by HR Dept)


Remaining leave entitlement for past period Leave entitlement for current period TOTAL : : : day(s) day(s) day(s) day(s)

Approved Leave
Remaining Leave entitlement per 2012 :

Requesting Employee,

HR Dept.

name & date

name & date

V. Leave Approval Reason

Approved

Refused

Adjourned

Approved by,

Acknowledge by,

Verified by,

manager

VP/Director

HR Dept.

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