Volunteer State Community College
Leave Reporting Correction Form
This form must be submitted to the Payroll Office to make manual corrections to a previous leave reporting period.
This form must be submitted immediately upon discovering leave has not been reported or needs correcting.
Employee Name _____________________________________________ Banner ID ______________________________
Reporting Period ___________________ through ___________________ Department ___________________________
I certify the hours below were taken in accordance with TBR & VSCC policies and guidelines and were not submitted
during the proper reporting period.
Employee Signature ________________________________________________ Date ___________________________
Please complete Item 1 OR Item 2 and Item 3 below.
(1) Leave not previously submitted:
AL (Annual Leave)
SL (Sick Leave)
BL (Bereavement Leave)
CT (Comp Time Leave-Non Exempt)
LWOP (Leave w/o Pay)
OTHER (Explain under comments)
Hours
Comments/reason for not submitting with reporting cycle.
(2) Leave as previously submitted that requires correction (must complete part (3) also):
Month Day Leave Type (listed above)
Hours
Taken Comments
(3) Leave as corrected from Part 2 above (must complete part (2) also):
Month Day Leave Type (listed above)
Taken Comments
Supervisor/Department Head - Certification/Approval:
I certify the hours above or correction to previously submitted hours were taken in accordance with TBR & VSCC policies
and guidelines and were not submitted correctly during the proper reporting period.
Approving Supervisor Signature ____________________________________________________ Date ______________
Department Head Signature _______________________________________________________ Date ______________
President, VP or Designee Signature (if required) ________________________________________ Date ______________
PYRL 08/2010
