MONTHLY LEAVE REPORT
N
OTE
-
T
HIS REPORT IS TO BE SUBMITTED TO YOUR SUPERVISOR AS SOON AS POSSIBLE AFTER THE LAST DAY OF EACH MONTH
F
OR
M
ONTH OF
:
Y
EAR
B
ANNER
ID
F
IRST
N
AME
L
AST
N
AME
EPARTMENT
Only to be completed by staff whose normal work week is 35 hours and 7 hours per day. Time off is to be reported in days. Report either
one day (1) or half day (1/2).
Section A
Day of
month
Days
Taken
Type of
Leave
Day of
month
Days
Taken
Type of
Leave
Day of
month
Days
Taken
Type of
Leave
Please total number of days taken for each
type of leave Record Half Day (1/2) as 0.5
1
12
23
Annual (A)
2
13
24
3
14
25
Sick (S)
4
15
26
5
16
27
Special (SP)
6
17
28
7 18 29
Bereavement (BR)
8
19
30
9 20 31
Overtime (OT)
10
21
11 22
Only to be completed by staff whose normal work day is other than 7 hours. This section also applies to those staff whose normal work week
Section B
is less than 35 hours. Time off is to be reported in hours and fractions of an hour.
Day of
month
Hours
Taken
Type of
Leave
Day of
month
Hours
Taken
Type of
Leave
Day of
month
Hours
Taken
Type of
Leave
Please total number of hours taken for each
type of leave
1
12
23
Annual (A)
2
13
24
3
14
25
Sick (S)
4
15
26
5
16
27
Special (SP)
6
17
28
7
18
29
Bereavement (BR)
8 19 30
9
20
31
Overtime (OT)
10 21
11
22
______________________________ _____________________________________________
D
ATE
E
MPLOYEE
'
S
S
IGNATURE
______________________________ _____________________________________________
D
ATE
A
UTHORIZED
S
IGNATURE
This form is confidential. The personal information provided is for leave and attendance management. When this form is submitted access is limited to persons authorized by Carleton University
who require the information to perform their duties.
monthly_leave_report
this law.
please contact the Assistant Director, Infrastructure and Renewal (Human Resources). Carleton University is fully compliant with FIPPA and
endeavours at all times to treat your personal information in accordance with
information provided will not be used for any purposes other than those stated upon this form unless the applicant provides express written consent. Should you have any questions concerning your personal information,
The personal information requested on this form is collected in accordance with Sections 38(2) and 41(1) of the Freedom of Information and Protection of Privacy Act (FIPPA), R.S.O. 1990, c.F.31 as amended. The
Revised:
22-Dec-2020
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