LEAVE APPLICATION FORM

Name (in full) : ENDARTO WAHJU T Designation :

Department : Tax Store/Location : HO

X Annual Leave 1 day (s) Compassionate Leave day (s) Replacement Off (RA) day (s)
No Pay Leave day (s) National Service Leave day (s) Replacement for - day
Medical Leave day (s) Child Care Leave day (s) Others
Hospitalisation Leave day (s) Maternity Leave day (s)

Leave to commence from : 04 Maret 2017

day month year day month year

Official Off Day : 09 Maret 2017

Replacement Off Day : 04 Maret 2017

day / month / year

Applied by, Approved by Supervisor, Acknowleged by HR Department,

Name : Endarto Wahju T Name : Name : MIRFINA WAHYU
Approved by Manager,
Name :

Signature : ___________________ Signature : ___________________ Signature : ___________________

Signature : ___________________
Date : 03-04-2017 Date : Date :
Date :
Compatibility Report for Leave form.xls
Run on 28/08/2015 15:52

The following features in this workbook are not supported by earlier versions of
Excel. These features may be lost or degraded when opening this workbook in
an earlier version of Excel or if you save this workbook in an earlier file format.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 4
boundaries of this graphic will appear clipped.
Sheet1'!B2:T49
 Version

Excel 97-2003