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Emp Absence

This document is an employee absence record form used to track dates and reasons for employee absences. It collects employee identifying information and lists months of the year with spaces to enter dates of absence and absence codes to classify the reason for being out. Common codes include vacation, sick leave, family illness, and jury duty. Managers can use this single form to easily review an employee's complete absence history for the year at a glance.

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John A Merlino
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© Attribution Non-Commercial (BY-NC)
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166 views1 page

Emp Absence

This document is an employee absence record form used to track dates and reasons for employee absences. It collects employee identifying information and lists months of the year with spaces to enter dates of absence and absence codes to classify the reason for being out. Common codes include vacation, sick leave, family illness, and jury duty. Managers can use this single form to easily review an employee's complete absence history for the year at a glance.

Uploaded by

John A Merlino
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Employee Absence Record (year)

Name Employee Number

Address Telephone ( )

City State Zip

Social Security Number Date of Employment

Department Position

Instructions: Enter the date(s) of excused and unexcused absences, with the appropriate codes. Use this form
to determine when vacation time and sick leave has been earned and used. This record makes it easy to review
the employee's absence record with just a glance. Use black for excused and red for unexcused.

Codes: V = Vacation, T = Tardy, U = Unexcused absence, S = Sick Leave, D = Death in Family, J = Jury Duty,
P = Partial Day, I = Illness in Family, _____ = _______________, _____ = _______________.

January February March


Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code

April May June


Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code

July August September


Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code

October November December


Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code Date(s) Code

Form 1006, Printed by:

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