Attendance Record Keeping Form
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1ATTENDANCE RECORD KEEPING FORM
Name: ____________________________
Employee/Payroll Number: _________
Dept. ______
Last
First
Middle
Hire Date:
/
/
Telephone: (
)
-
Vacation Days Due: _________ Sick Days Due: ___________
ATTENDANCE HISTORY Year _____________
A – Attendance
B – Birthday
C – Partial Hours Worked
D – Death in Family
E – Excused
F – Family Illness
G – Discipline
H – Holiday
I – Illness-Self
J – Jury Duty
K – Transportation
L – Leave of Absence
M – Military
N – Medical Appt.
O – Family/Medical Leave
P – Personal
Q – Early Quit
R – Recognition
S – Suspension
T – Tardy
U – Unexcused (AWOL) V – Vacation
W – Weather
X – Accident off the Job
Z – Layoff
1
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Tot
Sick Time
Vacation Time
Allowed
Taken
Available
Earned
Taken
Available
January
February
March
April
May
June
July
August
September
October
November
December
Warning Notices or Verbal Reprimands Given for Repeated Absences:
Date:
Comments:
/
/
G Verbal
G Warning Notice
/
/
G Verbal
G Warning Notice
/
/
G Verbal
G Warning Notice
HR-04 revised 10/04/99
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