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    F010 - Multi Purpose Form (Update2023)

    Uploaded by

    Bagus Susanto
    This form is used to request changes to an employee's personal information or employment status. It contains sections to fill out for new hires, personal data changes, job changes, rate changes, leaves of absence, employment history, pay rates, personal data changes, leave requests, and separations. The form submitted is for employee Bagus Susanto from the Finance division requesting 2 days of annual leave from September 29th to October 2nd, with a remaining balance of 5 days.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    F010 - Multi Purpose Form (Update2023)

    Uploaded by

    Bagus Susanto
    26 views2 pages
    This form is used to request changes to an employee's personal information or employment status. It contains sections to fill out for new hires, personal data changes, job changes, rate changes, leaves of absence, employment history, pay rates, personal data changes, leave requests, and separations. The form submitted is for employee Bagus Susanto from the Finance division requesting 2 days of annual leave from September 29th to October 2nd, with a remaining balance of 5 days.

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    © © All Rights Reserved

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    This form is used to request changes to an employee's personal information or employment status. It contains sections to fill out for new hires, personal data changes, job changes, rate changes, leaves of absence, employment history, pay rates, personal data changes, leave requests, and separations. The form submitted is for employee Bagus Susanto from the Finance division requesting 2 days of annual leave from September 29th to October 2nd, with a remaining balance of 5 days.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    26 views2 pages

    F010 - Multi Purpose Form (Update2023)

    Uploaded by

    Bagus Susanto
    This form is used to request changes to an employee's personal information or employment status. It contains sections to fill out for new hires, personal data changes, job changes, rate changes, leaves of absence, employment history, pay rates, personal data changes, leave requests, and separations. The form submitted is for employee Bagus Susanto from the Finance division requesting 2 days of annual leave from September 29th to October 2nd, with a remaining balance of 5 days.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Page 1 of 1

    MULTI PURPOSE FORM


    NO. F023/JHLC/HC/IV/2022
    ***FILL OUT THIS COLUMN FIRST 🡫 Date : 05-9-2023
    CHECK THE STATUS TO BE INITIATED BY THIS FORM PERSONAL INFORMATION
    ☐ New Hire ☐ Personal Data Change Full Name : BAGUS SUSANTO
    ☐ Job Change ☐ Separation Employee ID Number :
    ☐ Rate Change ☐ Leave of Absence Position : IT
    ☐ Others (Explain in remarks)__________________ Division/Department : FINANCE

    Basic Salary : Rp. (Net/Gross) Monthly


    Allowances : Rp. Daily/Monthly
    ☐
    Other Benefit :
    EMPLOYMENT
    Status : ☐ Single ☐ Married ☐ 1 Child ☐ 2 Children ☐ 3 Children ☐ Widow/Widower
    Employment : ☐ Contract ☐ Permanent ☐ Casual/Daily Worker
    ☐ FROM TO SOURCE
    MOVEMENT Position : Position : ☐ Internal
    ☐ Promotion Dept./Div : Dept./Div : ☐ External
    ☐ Transfer Level : Level :
    ☐ Merit Increment ☐ Promotion ☐ Adjustment ☐ Others:
    ☐
    Monthly Basic Salary
    PAY RATE
    From : Rp. (Net/Gross) To : Rp. (Net/Gross)
    ☐ Single ☐ Married ☐ Widow/Widower ☐1 Child ☐ 2 Children ☐ 3 Children
    ☐ Status :
    ☐ Other:
    PERSONAL DATA
    Family Card No. :
    CHANGE
    Address :
    LEAVE REQUEST
    No of days Leave Balance Remarks
    TYPE OF LEAVE FROM TO eligible Request Remaining
    (Days) (Days) (Days)
    ☐ (AL) – Annual Leave
    EMPLOYEE (DO) - Weekly Day/s off
    LEAVE/ (PH) - Public Holiday
    ABSENCE (DP) - Day Payment 29/09/23 2/10/23 7 2 5
    REQUEST
    (SL) - Sick Leave
    (CL) - Compassionate
    Leave
    (ML) - Maternity Leave
    (PL) - Hajj/ Pilgrimage
    Leave
    (UL) - Unpaid Leave
    Other:

    ☐ Voluntary ☐ Involuntary ☐ Other:


    Last day of : Last Employment : Last Entitlement :
    ☐ working Date of SC
    SEPARATION Eligible for rehire : ☐ Yes ☐ No Outstanding Leave (if any) :
    If no, please state the reasons:

    Date : 5/9/2023 :

    Employee/Requester : BAGUS SUSANTO


    Name
    Reason of Request : KELUARGA

    APPROVAL
    Date: Date: Date: Date: Date: Date:
    Page 2 of 1

    Employee Dept. Head Div. Head Human Capital Financial Controller General Manager
    Manager

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