Fillable Fm 424 Time Off TimeOff_form.indd

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Fm 424 Time Off TimeOff_form.indd

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TIME OFF AUTHORIZATION
Employee Name
Date(s) of Absence No. of Hours
REMARKS
Employee’s Signature
FM 424
Supervisor’s Signature
WHITE – Payroll Yellow – Employee
REASON FOR ABSENCE
®PERSONAL ILLNESS
®CRITICAL ILLNESS
®JURY DUTY
®FUNERAL LEAVE
®MILITARY LEAVE
®VACATION
®OTHER (Specify
in Remarks)
®HOURLY/NON-EXEMPT
®SALARIED/EXEMPT
®PAID
®UNPAID
Employee Name
Date(s) of Absence No. of Hours
REMARKS
Employee’s Signature
FM 424
Supervisor’s Signature
WHITE – Payroll Yellow – Employee
REASON FOR ABSENCE
®PERSONAL ILLNESS
®CRITICAL ILLNESS
®JURY DUTY
®FUNERAL LEAVE
®MILITARY LEAVE
®VACATION
®OTHER (Specify
in Remarks)
®HOURLY/NON-EXEMPT
®SALARIED/EXEMPT
®PAID
®UNPAID
Employee Name
Date(s) of Absence No. of Hours
REMARKS
Employee’s Signature
FM 424
Supervisor’s Signature
WHITE – Payroll Yellow – Employee
REASON FOR ABSENCE
®PERSONAL ILLNESS
®CRITICAL ILLNESS
®JURY DUTY
®FUNERAL LEAVE
®MILITARY LEAVE
®VACATION
®OTHER (Specify
in Remarks)
®HOURLY/NON-EXEMPT
®SALARIED/EXEMPT
®PAID
®UNPAID
Employee Name
Date(s) of Absence No. of Hours
REMARKS
Employee’s Signature
FM 424
Supervisor’s Signature
WHITE – Payroll Yellow – Employee
REASON FOR ABSENCE
®PERSONAL ILLNESS
®CRITICAL ILLNESS
®JURY DUTY
®FUNERAL LEAVE
®MILITARY LEAVE
®VACATION
®OTHER (Specify
in Remarks)
®HOURLY/NON-EXEMPT
®SALARIED/EXEMPT
®PAID
®UNPAID
TIME OFF AUTHORIZATION
TIME OFF AUTHORIZATION TIME OFF AUTHORIZATION
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Completed 27 February 2020

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