Ajourholdsliste pr 01.12.2005 for _____________________________________________________ (arb.givers navn) 

(01) Brukernummer: __________ (4 siffer)   (02) Organisasjonsnummer ________________________ (9 siffer)   Dir. telefon til saksbehandler: _____________________

Fødselsnr	St	Tjen.-	Navn	Begynt	Lns-	Arb.t	Til-	Still-	Rapport.-	Ut-	Lønns-	Lønns-	Deltid	Grunnlønn	Faste	Var.	Var.
11 siffer		sted	(etternavn/fornavn)	dato	ans.	pr u	sett	koder	betegnelse	dann.	sats 30.4	sats 1.12	%	pr mnd	tillegg	tillegg	overtid
03	04	05	06	07	08	09	10	11	12	13	14	15	16	17	18	19	20
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______
_____________	__	____	________________	_____	____	____	__	____	___________	_____	______	______	_____	________	______	_____	______

Fyll ut med én stilling pr linje. Tilsatte som innehar flere deltidsstillinger føres opp én gang pr stilling. Les veiledningen nøye!
Sendes i lukket konvolutt til: KA Kirkelig arbeidsgiver- og interesseorganisasjon, Pb 1034 Sentrum, 0104  OSLO. Merk konvolutten «LPR».