Please follow these instructions for completing your Monthly Absence Summary. If you have questions about completing this form, check with your supervisor or Human Resource Services.
- Month: Absences for exempt staff are reported from the 16th of the month through the 15th of the following month. Populate this field with the months affected by the absence summary. Example: June TO July
- Year: Populate with appropriate calendar year of the absence. Example: 2001 If the absence summary affects two years (Dec. 16 – Jan. 15), populate with both years. Example: 2001/2002
- Employee Name: Record your last name, first name, middle initial. Ex: Doe, Jane B.
- EmplID: Record your eight-character identification number. This number is used as your unique identifier.
- Department Name: Record the PS code for your home department. Example: CHUMNRESSV
- Date: No entry required for this field. Absences are reported from the 16th of the month to the 15th of the following month.
- Reporting the actual paid time off: Note: Report paid time off in hours and tenths
Minutes to tenths of hour conversion chart | |||||
---|---|---|---|---|---|
Time Off (minutes) | Convert | Time Off (minutes) | Convert | Time Off (minutes) | Convert |
0-2 | 0 | 21-26 | .4 | 45-50 | .8 |
3-8 | .1 | 27-32 | .5 | 51-56 | .9 |
9-14 | .2 | 33-38 | .6 | 56-60 | 1.0 |
15-20 | .3 | 39-44 | .7 |
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- Vacation/Sick Leave/Family Sick Leave/Personal Days: If the type of absence you are reporting is for vacation, sick leave, family sick leave or personal days, record the number of hours you were absent on that date within the column that describes the type of absence you are reporting. Example: 4.5 hours for 4 1/2 hours taken.
- Family and Medical Leave (FMLA): If you used accrued vacation, sick leave, family sick leave or personal days to cover a FMLA qualifying absence, check the box next to the hours reported.
- Other: Use this block to report absences other than vacation, sick, family sick, or personal.
Description | Type | Description | Type |
---|---|---|---|
Death, Immediate Family | DTM | Voting | VTM |
Legal Proceedings | LGM | Training | DRM |
Work Injury/Illness | INM | Orientation | ORM |
Military Duty | MIL | ||
Unexcused Absence | UXC |
- Comments: Provide information regarding the absence if necessary.
- Totals: If you complete this form electronically, the totals will automatically calculate. These totals will appear on your paystub as paid time off for the month.
- FMLA Total For Month: Enter total FMLA hours for the period. This field does NOT automatically calculate.
Note: FMLA is an acronym for Family and Medical Leave Act. - FMLA Begin Date: Record the date on which FMLA has been approved to begin.
- Employee Signature: Sign your name to certify any absences reported. Write in the date you signed the form.
- Supervisor Signature: Your supervisor must sign and date to approve the absences reported.
Reviewed 2019-08-05