b'Streamline Employee Absence Reporting and Time Off Requests ComplyRightRouting: Human Resources 2020 Time Off Request and Approval__________________________________ 2020 Time Off Request and Approval Absence ReportPlease Print__________________________________ Please PrintEmployee NameHillBarbara E2 Requesting time off has never been this easy! The15 18//_________________________________________________________________________ Date ______________Routing:LastFirstMiddle4536 Creative calendar format allows employees to clearly request Human ResourcesEmployee/Payroll # _______________________________________Department ________________________________________ 314Employee Hire/Service Date_________________ Status: Full-time Part-time __________________________________________// 13 dates in the upcoming months and also highlights legalThis repor __________________________________________Employee InstructionsComplete information above.Indicate reason(s) below.public holidays. Supervisors can see the bigger picture andt is for a : New absenceMake requests below by placing s in calendar days.Sign below and return to your supervisor for approval.NOTE: PUBLIC HOLIDAYS ARE HIGHLIGHTEDCJanuary February MarchLegal Public Holiday confidently approve time off with a 12-month overviewontinuation of a previously reporEmployee Name__________________________________________________________________________________________CohenMartin Johnted absenceJanuarySMTWTFS SMTWTFS SMTWTFS1New Years Day123411234567 20Martin Luther King Jr. Day right at their fingertips. 5412 First Employee/Payroll #Last 5678910112345678891011121314February________________________________________________________________________________________ 954 241-1212day Middle 121314151617189101112131415 15xxx xx21 17Presidents Day Telephone #_________________________________________ Shift_______________________________________________161718192014Valentines Day ()3123242526272829293031 March Daylight Saving Time begins Two-part carbonless form, one copy for employee,List Date(s) Absent________________________________________________________________________________________ 19202122232425 16171819202122 22232425262728 26Ash Wednesday 2627282930 817St. Patricks DayApril May June April Palm Sunday another for manager or HR department Absence Reported byEmployeeOther: 5 SMTWTFS SMTWTFS SMTWTFS8-16 Passover123412123456 10Good Friday Was notif His/Her Name_________________________________________________________56789101134567897891011121312Easter SundayEmployees mark their time-off requests byMartin Cohen 12131415161718 10111213141516 14151617181920May Telephone #( _22Administrative Professionals Day ication of absence received in a timely fashion?____ ___ ___ _)________________________________________________xx19202122232425 17181920212223 2122 2324252627 10Mothers Day indicating the requested dates of the yearNoAbsencePaidUnpaidOtherYes 16Armed Forces Day24 262728 29 30 31 252627282930 28293025Memorial DayJuly Routing: Human Resources September June Flag Day Includes a ComplyRight guide to help you manage Absence ReportIf medically treated, was a doctor seen?_____________________________________14 AugustYesNo2020 Time Off Request & Approval ____________________________ 21Fathers DayPlease Print SMTWTFS SMTWTFS SMTWTFS July Independence DayIf the absence exceeded three days, was physician certification requested?YesNo12341123453(observed) time off requests the right way____________________________56789101123 Human Resources 6/786789101112 4 Independence Day To: __________________________________ Date ___________ If so, did the employee provide this?YesNoEmployee Namexxx Routing:45/______________________________________________________ Date _____________2020 Time Off Request & Approval ____________________________ xxxxx 19September 121314151617189101112131415 1314151617187Labor DayLast First MiddleEmployee/Payroll # ________________________________Department ____________________________202122232425261 8-20 Rosh Hashanah Employee ____________________________________________ 19____________________________ Reason for AbsencePlease Print 202122232425 16171819202122 Employee Hire/Service Date _____ / _ ____ ___ 3 1 Stat us:2 3 Fu2ll-time 25Par 6ime 2829 27282930 27-28 Yom Kippur___/ 4 t-tEmployee Name2829 30 3031 2 27/ / October 2627______________________________________________________ Date _____________LastFirstDepartmentoer.Middle December 12Columbus Day DescriptionItem #Price Employee # ___________________________________________Employee Instructions _____Accident on the Job _____Family LeaveEmployee/Payroll # ________________________________ Nos) bel ____________________________ Complete OcftoberIndicate reason(vembw 16National Boss Dayinormation above. Make requ SMTlacin Ws/ / F Si Sand return to y Tr su Wrvisorfor approva S SMTWTFS31Haloween Type of occurrence:TardinessAbsenceVacationin calendar days. 1231NOTE: PUBLIC HO 4DAYS A 6712345 1Daylight Saving Time ends Standard 2-Part CarbonlessPB1-A0030$70.99 _____ Accident off the Job _____Holiday _____LEmployee Hire/Service Date ________________gn below SMou pe T RE HIGH FGHTED l. Novemberests below by p gTStatus: Full-timePart-time LILILegal Public Holiday _____ eave of AbsenceEmployee Instructions 23 5January M 4T5 F S 6February 8WT 9FMarch T9T10F11Ja1 12 V y 13s 146789101112 3Election Day Dept. ________________________________ Shift ___________ _____ Death in Family _____ _____Medical Appointment _____SuspensionComplete information above. S Indicate reason(s) below.1 IllnessFamily _____ Medical Leave _____Tardy/Leave EarlySMTWS7 M T10SM 8 WS nuary New Years Day 11Veterans Day 567in ackaele rnedqaure sdtasy bse. low by placing s167Sign below and return to your supervisor for approval.1314151617181926Thanksgiving Day Standard PB1-A0037$46.99 Educational _____ IllnessSelf1 234 112345 6 720 Martin Luther King Jr. Day 11912132144155617 8 1510161718Februar 2021 810 11389111213 1419 121314 January17 18 910 February1314 15 151March 18NOTE: PUBLIC HOLIDAYS ARE HIGHLIGHTED December Time due at work___________Actual arrival time ___________ _____ Excused*Jury Duty _____ Military _____Unexcused*15 1611 1261719 20 217 alesnidtiennet s Daayy 4Legal Public Holiday 192021 182319 1 T20 16 S 21 S2 2 2 6T23 212 2 4S223 22M23W241 F251 26 P re 27D 28 2021222324252610-18HanukkahS22TW25 F4 172 18 M 194 20T 221 292399 24 T 2511 261 T 27628 S Jan1uarNy ew Years Day2728293031 25Christmas Day 262728M302 24227 232 2 8 25 9 27 W2831 FS0 230 527 March Martin Luther King Jr. Day 31New Years Eve Compact 2-Part CarbonlessPB1-A0045$49.99 26 Ash Wednesday _____ _____Personal Day Vacation291 3 5 7 13February8 14 6 6 8St. Patricks DayApril5 25 7 1 3 9 1011 49 2 3 30 6 9 88 2 31 17 419230 14 17 1 20Daylight Saving Time begins P SM12 13T25216 S May 16 T17 W 1 T 1 F3S 22 June 16 1 0 18 T26F27S 21Ap5r il7 Valentines Daayy _____15 *Reason for absence, as explained by employee1962 114 F203 17 1 M 2310 18 19210 1415S 22 23 2432545628 10 26 E Palm Sunday Price per pkg/50. Standard: 8" x 11", Compact: 5" x 8" Reason for Occurrencesevere cough and fever _____ ______________TWS 285 1 2 MTWMarch Arsehs Wideednntess dDay2 270 28 or Request: _________________________________________________________________________________________2 1 29 34214 24 25 26 17 218 29 29 30 3181-16 PassovFerirdayReason f 33 2 2 122 8 Gaosotde r Sunday22Daylight Saving Time begins 1213141516W18F10S 11 S12M13T141516S 1415MT17W18T19F20S8-51 61 2 Pa ESunday1Lack of work 11Death in family___________________________________________________________________________________ 567April 910 11 34May 6789 789101112 13MAp 1r7i l St. Patricks Day ionals Day85June 22 Administrative Profes ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________SMT17T317 4 181920WTF2S162 24 3 25 4 26 5 27 6 ay Mothers Day 192021222324 224125326 4272122 239 2122 19 11 13 162 Palsmsdo v Ferirday ionals Day 2627 2 Co 26712510 31 1110 111 52 287 12829 8 2316 17 18 192 20 10 10 Gaosoter Sunday2Sick (employee) 12Jury duty/courtArmed Forces Day _________________________________________________________________________________________________________________________________1 8mments:_________________________________________________________________________________________________15 1617 813 14 30 14 15 0 M2ay Administrative Profes155930 8 9 6 298 16 7 30 1 1 Ju2n5e Memorial DayJuly12 10 11 24August 1 2 2 September 24 25 26 27 14 Flag eDrasy Day9 2 32 4 2524 T 2 W296 T2F2923 S2M2 T2 WTFS Ju3ly 10Fath F s Day26 27 28229 203SM 17 185 207218S 230218 292 33021Mromtheedr rFiaolr cDeasy Day SM___________________________________________________________________________________________________________ 56TWT2 1 Fe 3 TS ig n 2 3 atur 2 1 31 August T6W7T1S 67M1T2W3T4F5S Sep725R Memo hanah Date//3Family sickness 13Birthday BESTSELLERList follow-up action scheduled, if any, with the employee and list the date16 A1234Independence Day 7July 910 11F2S 3S4M5131481 13SSeptember 103 114 12Jun4e (observed) ________________14Military 11 Flaatghe Drasy Day8TWF89Independence Day15182ly Independence Day_______________________________________________________________________________________________________________________________________1213SEmployes S 3 94 10e________________________________________________________________4Accidentself or family14M16172 1112151415161718 194 temLbaebror DayJu3 _____________________________________________________________192028Su 6ervisor 9 S 510 16 1 1 a1t7 ur3 1e 2 3 11 W 94 2021 222 8 S2 6 2 7T2 1 232 2 2410 2511 2652 2 1782280 C (observed) Date// out of plant15Weather26272122 23 24 2 ign 34 2 8 10________________________________________________________________ ________________1522 p 7 8 s S 30 18925265 6 7 2021228 30 9 1 4YoomshKHipapsurIndependence Day _________________________________________________________________________________________________________ 13141516 17112728 29151329October930 31 12 13 142728 SM 2 Auth 2182 Fd Approva l17 185 1 207 28 229 20 14 12 W13 T14 F15 S 16 Se7p temLbaebrorH Daashyanah Date ________________T2 2 orize 2 214S25M16T34 2 296 2 2 1 72185 6 2 7 2 8 2 9 1 6 Rosh//October 9207 T2293033 November ________________________________________________________________16 W 230 TFS December 29 30 18-20Noaltuiomnablu Bs oDsasy Day Supervisor Comments12M 27c-to28b eYrom KippurA pproved Denied Commen ts: __________________________________________________________________________ 15Plant injury 16Medical appointmentNo3v1e mHbearloweenDayOctober12312 November567SDecember W3T4F5S O12 Columbus Day3412136 Natlioownaele Bnos ________________________________________________________________________________________________________________ 45671 T1 W2 102 F 82 S 9 2 S 10 M 11i T12ct 13i de 14s s neS 1 6opr 1 7v M 8T1 9a g te10d 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Y 252627282930 31 2930 24 25 26 27 282 2829302331 24 25 26. T 1is N h aniuk mmay not be shared publicly or with third parties.7Discipline 18Floating holiday2735 fotk ma _________________________________________________________________________________________________________ 18516 2 728 29233034229203 20 21 2230 31 D 1e 2 ember C r s D2 2 9 20 2 1 13 Important note: This is approved for use by the purchaser only2 0c-1 8Cew Years Eve 728 29 A0030_2020 2019 ComplyRight, Inc. Two easy ways to reorder: hrdirect.com800-999-91111Hharniusktkmaahs Day35 New Years Eve Reason for Request:_____________________________________________________________8Leave of absence 19Comp timeReason for Request:____________________________________________________________________________________________________________________________________________Comments: _____________________________________________________________________9Transportation 20Family leave_______________________________________________________________________________Comments: _____________________________________________________________________Standard Super Date______________________ _______________________________________________________________________________ visor/Designated Manager Signature / /_______________________________________________________________________________10Unknown 21 Other_______________________/ / Carbonless 2016 ComplyRight, Inc. a l T r h a a i t st p r r i o i du i o c n tsi n si c s d t e a i s b i i g n n t s i e p dc t t oifi p i p r f ov c t o i f i t d sel a a ____________________________________________________________ i it i t t t l i i l f i t f itti t l i if i i i f i f i ti t i i i it t t ii t i i lit t t t i . tt f ti l i t it i le e o ti p t r Date i ti l g___________________Employees Signature________________________________________________Date ______________Employees Signature________________________________________________ Date ______________ Notice received:By phone Written In person None/ /Supervisors Signature ________________________________________________ / /Supervisors Signature ________________________________________________ Date ______________/ /Date ______________Authorized Approval________________________________________________Date ______________ From: Employee Authorized Approval________________________________________________ / /Other_____________________________Date ______________ A2250 I p eg o lr o t c p n no c ro t d onr n i nyi gn e ou r h ca p a r cu orc s s c e s u r b r v a o c es a .nd au o h s o e r r rs a p a e a venn h so p r r m r a s d o e n. Howe c v e e r r,h s tesr no a ta al s i ub l s e ha u teit eorth e i r g s a o l a a dv t c i e c .s e. and does n d n c ov ea d s en t,/ // / Approved Denied __________________________________________________________________ Request for Time Off odu a gnoe: Thsu s a y gp rse r ductes n ua e o a T u heh n a om d c o ages a ov o n do w thn he unde o s n ndngo u anyh pe pr n or nt ya nvov gd o c r onu Approved Denied __________________________________________________________________ noneyer p ovd or u yte p b a er anyn m T c que r s mn g ou c of hes u sa y r o rm u bi h c yor w s hsrdodu e You re urThis product is designed to provide accurate and authoritative information. However, it is not a substitute for legal advice and does norto dpurocvinidge o lre gdails torpibiuntioinngs t a Will return to work _____________________________________This product is designed to providee a icncfuorramtea atinodnaisu pthroovriitdaetidv ew iinthfo trhme autinodne. rHstaowndeivnegr, t iht aistannoytpa esrusbosnti otur teen ftoirt yl eignavlo alvdevdic ienacnrdea dtionegs,nporto dpurocvinidg eo lre gdails toripbinuitionngs Request for Time Off mp ntrn nd ny thairsticular situation and a ervicesy.Tdahme aingfeosr amriastiinogn o ius tp orof vtihdee dus we iothritnhaeb uilnitdye tros tuasned tinhgistphraot dauncyt . pYeorsuo anr eo ur ergnetdit yt oi ncvoonlvsueldtianncartetaotrinnegy,pconcerning yourh rca o y.s o s rn o t ben e up ay av any specific factlsiaanbdle a fnoyrsapecificohnirst ipcruoladru csitt uisa tnioontor servicensy.Tdahm qaugeesst iaornissi nogrcouont coefr tnhseyuosuemora iyn haabivleit.y to use this product. You are urged to consult an aton a npyro sdpueccti fiisc n faoctt lsi aobrl es fnoyraspnecific questions or concerns you may have.p p orney concerning your A0045_2020Important no Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties. Name ______________________________ Date ____________________ Recommended action: Make up time Deduct pay None may o db yprte: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties.Two easy ways to reorder: hrdirect.com800-999-9111 A0808-AbsncRprt.indd 1A0045_20202019 ComplyRight, Inc. Two easy ways to reorder: hrdirect.com800-999-9111 Name ______________________________ Date ____________________2019 ComplyRight, Inc.Department __________________________ Status: Full timePart timeRefer to Human Resources for FMLA reviewDepartment __________________________ Status: Full timePart timeCompact ID number ______________________ Hire/seniority date_______________ Comments ___________________________________________Comments ___________________________________________ID number ______________________ Hire/seniority date_______________Supervisors name ______________________________________________Supervisors name ______________________________________________ ___________________________________________________ Standard9/28/16 12:51 PMTitle _______________________________________________________ComplyRight Title _______________________________________________________ AMRequested date(s) off ____________________________________________ Time _________ By _________________________________ ComplyRightRequest for Time Off Requested date(s) off ____________________________________________ PMTime of departure ______________________________________________ This product is designed to provide accurate and authoritative information. However, it i s t hnoeo tu an dsuerbrbssttaitnudtien fgo rt h leatg aaln ayd pveicrseo o ann dor r d eonetsi tny o otAbsence ReportTime of departure ______________________________________________Time of return________________________________________________ 2016 ComplyRight, Inc. provide legal opinigged to consult an at i orney concerning your p rmation is provided withsh ayr isspinegc iofoiuctqouf e tshteieo unsse o orr c ionnacbeirlnintsysytoo uu sme atyh ihsa ave.inrvoodluvecetd.YiYino ucr raeraet i ununr ons roond uacnciyn gsgsp oerc idfiiicscs t rfaibctutst ionrg s tehrvisi cperso. dTuhcetiiinsns fnooat r rltiiacbullela frfo sri taunayt i iododnanm anagde sang,n, pTime of return________________________________________________ ppManage time off requests to avoid conflicts andReason for request ______________________________________________ A2151 Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties.Reason for request ______________________________________________ Use this form to simplify absence reporting and enforce company __________________________________________________________give employees a written record. Establish a fair and____________________________________________________________________________________________________________________ Compactattendance policies. Provides 20 specific reasons for absences__________________________________________________________efficient process with documentation for reference. Signature of employee___________________________________________Signature of employee___________________________________________ and space to add your own reasons.Time off: ApprovedDeniedTime off: ApprovedDeniedTwo-part form provides copies for the employeeRequest approved/denied by: _______________________________________Request approved/denied by: _______________________________________ Multi-part forms provide copies for the employee,Title _______________________________________________________and manager Title _______________________________________________________Reason for approval or denial _______________________________________ payroll and/or HRReason for approval or denial _______________________________________Includes a ComplyRight guide to help you ____________________________________________________________________________________________________________________ Includes a ComplyRight guide to help you managemanage employee absences the right way ____________________________________________________________________________________________________________________For office use only. . employee absences the right wayFor office use only Paid absence Unpaid absence Paid absenceUnpaid absenceIf paid, deduct from:Personal Vacation Sick OtherItem #Price If paid, deduct from:Personal Vacation Sick Other DescriptionItem #Price ExcusedUnexcusedPrevious Occurrences Yes No ExcusedUnexcused Previous OccurrencesYesNoPB1-A2203 $52.49 _________________________________________________________ Compact 2-Part CarbonlessPB1-A2151 $48.49______________________________________ ___________________SuperSupervisorvisors signatures signature T itleTitlePrice per pkg/50. tStandard 3-Part CarbonlessPB1-A2250 $81.99ThiTs hpriso pdruocdt uics td ies sdigensiegdn teod ptor opvriodvei daec caucrcautrea aten dan adu tahuothriotraitiavteiv ien ifonfromramtaiotino.n H. Howowevevre,r i,t itis i sn onot at as usurbesrsbtstsatitntaiuntdutdietnie fn gofg ortrthlh ealaegt gaa alan lny ayd d pvpveieicrcrseso oann odor rdd eonetsi t ntynyo o Size: 5" x 8" 201260 1C6o CmopmlypRliygRhigt,h Itn, cIn.c. p inrvooipvnlirvdvoeeovd lilvd eienegd a l celi rgnoe aapcltr inioenapigotin,in npisogr on,o pnsd ruoaoncdiy una ncsgpi yno egsrcp idoefiirc sid tfriiasicbct frtuaistcb iotunsrtg io nstregh rs ivteshi rcpivseir scpo.e rdsTou.h dcTuethciietsnfiinnso orfnotm orlmitaa tlibiaaoltebnio l fenio s fr iops a rrp noaryvno idyvd iadedmdae mdaw gawietgshiet hs at h ratieshri esnu iungngd noed uout to of ft hthei euon nussss eoeoo rorr c r ci onionnanacbcbeierlirnilntisytys y tytoooo u uuu smse a tatyhyh ihshsa a ve.A22A023203 propIdpomurrocptdtao.nu rYct toan.nu oYt ta oenru:oeTatuerh:re ig Tsue hridgis s tea odips pcatoropon pcvsroeuondvlst u efadolnt r faouanrtsteoua tsrbtenyo e brtnyhy e ectyh op cneuo cprneucrchnreacirhnsneagirnsyeogro n yuolorynu .p lryT.aphTraithisrc itfsuioc lrfauomlrra m srmi t sumiatyauat anyiot oinnoto n atb n aebn des d has ahnarynae rysde pd sppe puceibucflbificcil icqcly lqu you eoesrtr sw itowith third parties. Price per pkg/50. Standard 8" x 11", Compact 5 x 8Im ith third parties.10 ATTENDANCE TRACKING HRDIRECT.COM800.999.9111 11'