Sept. report of absence form june2013 signed
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This document is a report of absence form for an employee named Betty M. Miller from the Advancement department. It indicates she was absent for 8 hours on September 29, 2014. The form requires her employee ID number and signatures from her and her supervisor to approve the absence reason and time taken.
Sept. report of absence form june2013 signed
- 1. REPORT OF ABSENCE NAME (PRINT) Employee ID# (required) Department DATE(S) OF ABSENCE NUMBER of TOTAL HOURS Reason for Absence 1. VACATION: Please select if applicable: FMLA qualified (Sick hours must be used first. Vacation hours are used only after all sick hours are exhausted) 2. SICK: Self Family Member (relationship: _______________________________) Please select if applicable: FMLA qualified 3. WORKERS COMPENSATION: I choose to take this time as Unpaid Sick Vacation (Sick hours must be used first. Vacation hours may be used only after all sick hours are exhausted) 4. PERSONAL DAY (Floating Holiday). Please note: this benefit must be used as a full day. It is not available in incremental periods. 5. BEREAVEMENT (relationship to deceased: __________________________________) **NOTE: Advance request for vacation or scheduled illness should be submitted to the Human Resources Office as soon as possible. Submission must be made immediately to record other absences involving Workers Compensation or extended absence for a serious medical illness for yourself or a family member (i.e. For extended absence to care for a family member, Family Medical Leave Act documentation must be filed on the first day you are absent from Florida Southern College). __________________________________ __________________________________ Employee Signature (date) Supervisor Approval (date) Revised June 2013 Betty M. Miller Advancement Sept. 29, 2014 8 x Betty M. Miller 1179085