REV 3/06 PAY PERIOD
IDAHO STATE UNIVERSIT
From
Name
NON-CLASSIFIED* EMPLOYEE
ABSENCE REPORT
Thru
Social Security #
Pay Date
Department
Were you absent from work during this bi-weekly period?
NO
Check the box and sign below.
YES
Check the box, record the hours absent for each work day on the
appropriate line, and sign below.
< < < < < < < < < < < < < < < < < < < < DAY > > > > > > > > > > > > > > > > > > > >
TOTALS
SUN MON
TUE
WED
THU
FRI SAT SUN MON TUE WED THU FRI SAT
SICK LEAVE USED
VACATION LEAVE USED
OTHER ABSENCES
DAILY TOTAL
EXPLAIN ALL "OTHER ABSENCES" ABOVE. (Example: Holiday, Doctor Appointment, Etc.)
* Non-classified employee is any person (excluding faculty with a 9, 10, or 11 month contract) appointed to or holding a position at Idaho State University whose position is not subject to provisions of the Idaho Personnel
Commission concerning the merit examination, selection, retention, promotion and dismissal requirements as provided under Title 67, Chapter 53, Idaho State Code.
I hereby certify the record of hours absent for each work day as set forth above is true and accurate.
EMPLOYEE SIGNATURE SUPERVISOR SIGNATURE (Optional)
