STATE OF CALIFORNIA
ABSENCE AND ADDITIONAL
TIME WORKED REPORT
STD. 634 (REV.5-98) (REVERSE)
INSTRUCTIONS
1. Enter pay period, month, and year, and complete other boxes as required by your
department.
2-4. Complete name, social security number, and position number.
5. Absences with Pay--Check appropriate box, indicating type(s) of absence(s).
6. Absences Without Pay (Dock)--Complete all boxes, indicating type of unpaid
absence and if the current pay period is qualified or nonqualified. Last box can be
checked if employee is serving a probationary period to determine if employee will
complete required number of working days.
Qualifying Pay Period--Eleven (11) or more paid days in a monthly pay period.
Nonqualifying Pay Period--Less than eleven (11) paid days in a monthly pay
period.
Note: If the employee is absent without pay for more than eleven (11) consecutive
working days, which falls between two (2) consecutive otherwise qualifying pay
period, one (1) pay period shall be disqualifying.
7. Dates of Absences and Extra Hours Worked
7a. Enter time to be paid for each day, including paid absence hours for
intermittent or part-time employees.
Note: Enter all hours to be paid in the total column.
7b. Sick and Sick Family--Provisions on the usage of sick and family sick leave
are outlined by the memorandum of understanding between your exclusive
representatives and the State of California.
Indicate sick leave hours with a symbol "S" or "SF" on date of absence. If more
than two (2) hours are needed for a doctor's appointment, the reason should
be stated in Item 8. Enter the symbol and the number of hours under the
number(s) corresponding to the duties being reported.
7c. Bereavement Leave--Provisions for bereavement leave are outlined by the
memorandum of understanding between your exclusive representative and
the State of California.
7d. Vacation may be used in 30 minute or one (1) hour increments as outlined by
the memorandum of understanding between your exclusive representative
and the State of California and is shown on the appropriate date with the
symbol "V"..
An absence can be charged against vacation credits only when approved by
the appointing power. The time at which vacation shall be taken may be
specified to suit the convenience of the department. Vacation cannot be taken
as an absolute right unless the appointing power does not provide a vacation
for the employee for two successive years.
7e. Annual Leave--The "A/L" symbol shall be used to indicate when annual
leave credits have been used.
7f. Post proper symbol and number of hours for type of absence being reported.
ML—Monitoring Leave—eligible employees may recieve up to 40 hours
mentoring leave per claendar year once they have used an equal amount of
their leave or personal time for this activity.
FM—Family and Medical Leave Act—under certain conditions, entitles
employees up to 12 weeks of unpaid leave per year.
Paid Educational Leave--Following completion of twelve (12) qualifying
pay periods of continuous service, a full-time employee in State civil service
employed in a position requiring teaching certification qualification shall be
allowed fifteen (15) days credit or educational leave with pay. Thereafter, on
the first (1st) of the pay period following each additional qualifying pay
period of service, he/she shall be allowed one and one-fourth (1-1/4) days
credit for educational leave with pay. The employee may earn or use
educational leave credit only while in a position requiring teacher certifica-
tion qualifications. The granting of paid educational leave is at the discretion
of the appointing power.
Military Leave--Attach a copy of any applicable military order. Every
calendar day must be recorded, including any Saturday, Sunday, or holiday.
Jury Duty or Subpoenaed Witness--An employee may be absent with pay
for time actually served to perform jury duty or for time subpoenaed as a
witness in a court case when the employee is neither a party nor an expert
witness, providing the employee remits the fee to the State. If the fee is
retained, either a charge is made against the employee's accumulated leave
balance or absence is without pay. It is up to the employee to demand of the
party requesting their appearance a subpoena and whatever fees and travel
allowance that may be allowed by law. Witness fees for a civil trial are
governed by Government Code Sections 68093-68096 and the fee for a
criminal trial is governed by Penal Code Section 1329. The employee may
keep travel allowance.
7g. Post proper symbol and number of hours for type of absence reporting.
Approved absence without pay--Approved dock
Absence without pay--AWOL
7h. Enter symbols and hours to be compensated at straight time as indicated
below:
WO -- Overtime worked for CTO
P -- Overtime hours worked for pay
HC -- Hours worked on a holiday
WE -- Excess hours worked due to irregular work shift
7i. Enter symbols and hours to be compensated at premium time as indicated
below (Personnel Office will convert to time and one-half (1-1/2):
WO -- Overtime hours worked for CTO
P -- Overtime hours worked for pay
Note: Total column may be used for Items 7b through 7i.
8. Reason for Absence or Extra Hours Worked--Employee must indicate reason for
sick leave absences, including relationship of family member when reporting
family sick leave.
Note: This item also can be used for reporting reasons for overtime hours worked
or for unpaid absences.
9. Employee's Responsibility and Signature--Employees have the responsibility to
give their supervisor advance notification when they anticipate a future absence.
When unanticipated emergency causes the absence, the employees are responsible
for notifying supervisor as soon as possible and keeping their supervisor informed
as to the possible date of return. Employees are also responsible for promptly
reviewing and signing their absence report at the end of the pay period and
submitting to supervisor.
10. Recommendation of Supervisor's Responsibility--Each supervisor is responsible
for seeing that employees comply with the regulations governing absence from
work. The supervisor is expected to recommend against approval of sick leave
absences when satisfactory evidence as to need is not presented. Supervisor is then
responsible for promptly reviewing and signing the employee's absence report and
forwarding it to the Personnel Office.
Before recommending approval for sick leave by an INTERMITTENT EM-
PLOYEE, supervisor shall certify that the employee was scheduled to work during
the hours reported for sick leave.
Note: Methods of verification can include telephone, physician statement, home
or hospital visit.
11. Statements by Physicians--If physician statement is attached, check first box and
do not complete other information in this item.
If supervisor has requested the physician's verrification on this form, second box
is checked and the doctor completes each item and signs the form.
12. Applicable information regarding absences due to industrial injury or
13. Illness should be recorded in this area.
14. Completed by Personnel Office only.
INSTRUCTIONS FOR FILLING OUT FORM STD. 634 BY ITEM NUMBER (see reverse side)
2. Prepare the number of copies required by our department. Employees who want a
copy for their own records, indicating supervisor's signature, may prepare an extra
copy.
WWG 4C EMPLOYEES MUST CONTACT THEIR PERSONNEL OFFICES FOR INSTRUCTIONS
GENERAL INFORMATION
1. All absences or additional hours worked by full-time or part-time employees should
be reported on one form STD. 634 for each pay period. Report all time worked for
permanent intermittent and part-time employees.
