Supervisorís Report of Exempt Employee Absence

 
Name:   
Department:    
Month:    

Absence Codes

  • A = Accident On Duty (Please Specify)
  • AO = Accident Off Duty (Please Specify)
  • BD = Birthday (Please Specify)
  • CB = Away on College Business (Please Specify)
  • DF = Death in Family (List Family Member and Location)
  • JD = Jury Duty (Send Documentation)
  • H = Holiday
  • P = Personal (2 days per year)
  • SF = Sickness in Family (10 Days per year)
  • SS = Sickness/Self (Including maternity leave)
  • V = Vacation
  • W = Weather (approved paid or unpaid)
  • O = Other (Must Specify)


 
Date(s) of Absence Absence Code Hours/Days Absent Comment
       
       
       
       
       
       
       
       
       

Employee Signature: _________________________  Date: ________

Supervisor Signature: _________________________  Date: ________