STATE OF CALIFORNIA − PERSONNEL ADMINISTRATION
ABSENCE AND ADDITIONAL
TIME WORKED REPORT
STD. 634 (REV. 8/2002) (REVERSE)
INSTRUCTIONS
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
2.
Prepare the number of copies required by your department. Employees who
should be reported on one form STD. 634 for each pay period. Report all time
want a copy for their own records, including supervisor’s signature, may
worked for permanent intermittent and part-time employees.
prepare an extra copy.
INSTRUCTIONS FOR FILLING OUT FORM STD. 634 BY ITEM NUMBER (see reverse side)
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 fall between two (2) consecutive otherwise qualifying pay
periods, 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.
Sick Death–Employees in bargaining units which did not negotiate
bereavement leave provisions may use up to five (5) days of their sick leave
balance for each family member.
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–Mentoring Leave–eligible employees may receive up to 40 hours
mentoring leave per calendar 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
certification qualifications. The granting of paid educational leave is at the
Jury Duty or Witness–An employee may be absent with pay for time
actually served to perform jury duty, for time as a subpoenaed witness
(other than a party to the suit), and for time as an expert witness testifying
on behalf of the State. It is up to the employee to demand of the party
requesting their appearance a subpoena and all allowable attendance and
travel fees. The following absences are not compensable and the employee
must charge leave or absence without pay: 1) subpoenaed witnesses who
are a party to the suit, 2) subpoenaed witnesses not testifying on behalf of
the State who elect to retain the attendance fees, 3) expert witnesses not
testifying on behalf of the State, and 4) jurors who elect to retain the
attendance fees. Subpoenaed witness fees for a civil trial are governed by
Government Code (GC) Sections 68093-68097.10, fees for a criminal trial
are governed by Penal Code Section 1329-29.1, and expert fees are
governed by GC Section 68092.5. See SAM Sections 8594-94.3.
7g.
Post proper symbol and number of hours for type of absence reporting.
Approved absence without pay–Approved dock
Absence without pay–AWOL
An Unapproved Absence Without Pay—Can be any amount of time. If
the absence exceeds five (5) consecutive working days, this constitutes an
automatic resignation from State service pursuant to Government Code
19996.2 (without fault) or an adverse action can be taken under
Government Code 19572 (with fault).
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–Indicate reason (not a description
of illness, condition or diagnosis) 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
EMPLOYEE, 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 Physician–If physician statement is attached, check first box
and do not complete other information in this item.
If supervisor has requested the physician’s verification on this form, second
box is checked and the doctor completes each item and signs the form.
discretion of the appointing power.
12-13.
Applicable information regarding absences due to industrial injury or illness
should be recorded in this area.
Military Leave–Attach a copy of any applicable military order. Every calendar
14. Completed by Personnel Office only.
day must be recorded, including any Saturday, Sunday, or holiday.
