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SURAT IJIN DAN CUTI ONLINE
Form Permohonan Cuti Online
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1
Nama
*
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Nama lengkap
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2
NIP
*
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masukan NIP anda
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3
Jabatan
*
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masukan jabatan
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4
Jenis Cuti
*
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Pilih jenis cuti
Cuti Sakit
Cuti Tahunan
Alasan Penting
Cuti Bersalin
Cuti Besar
Cuti Diluar Tanggungan Negara
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5
Tanggal Permohonan Ijin
Tgl
Bulan
Tahun
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6
Sampai Dengan Tanggal
Tgl
Bulan
Tahun
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7
Kepada
*
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Permohonan Ijin ditujukan kepada:
Ketua PTUN Kupang
Panitera
Sekretaris PTUN Kupang
Panitera Muda Perkara
Panitera Muda Hukum
Kasubag PTIP
Kasubag Ortalak
Kasubag Umum & Keuangan
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8
Nama Pimpinan
*
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masukan Nama Atasan Langsung lengkap dengan gelar
Nama lengkap
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9
NIP Pimpinan
*
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masukan NIP Atasan Langsung
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10
Alasan
*
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Tuliskan alasan Anda mengapa ingin mengajukan Permohonan Ijin
Tuliskan alasan Anda mengapa ingin mengajukan ijin
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11
Alamat Selama Cuti
*
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Tuliskan alamat anda selama masa cuti
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12
E-mail
*
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kupang@ptun.org
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13
No. Handphone
*
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Nomor handphone
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