NAME: Banner ID: 900-
PAYDATE:
DATE REG AL SL CTU CTE HOL OVT Other TOTAL
TOTALS
ACCOUNT NUMBER REG AL SL CTU CTE HOL OVT Other TOTAL
Employee Signature Date Supervisor Signature Date
*OTHER: PD = personal day, FL = funeral leave, EL = emergency leave, ML = military leave, FSL = family sick leave, FAL = family annual leave
Payroll Use Only:
Entered By:
Verified By: