Web Lea
ve Entry Corre
ction Form
This
f
orm must be submitted to the HR Office to make manual corrections to a previous leave reporting period. This
form must be submitted immediately upon discovering time has not been reported or needs correcting.
Employee Name _____________________________________________ Banner ID ______________________________
Reporting Period ______
_____________ through ___________________ Department ___________________________
I certify the hours below were worked and not submitted with a prior time reporting period or were submitted
incorrectly through a prior time reporting period.
Employee Signature ________________________________________________ Date ___________________________
Please complete Item 1 OR Item 2 and Item 3 below.
(1) Leave not previously reported:
Month Day
Position
Number
Leave Not Reported
(Ex. 7.5 Hours)
Comments/reason for not submitting with reporting cycle.
(2) Leave as previously reported that requires correction (must complete part (3) also):
Month Day
Position
Number
Leave Reported
(Ex. 7.5 Hours)
Comments
(3) Leave as it should be reported (must complete part (2) also):
Month Day
Position
Number
Leave Taken
(Ex. 7.5 Hours)
Comments
Supervisor/Department Head - Certification/Approval:
I certify the hours above or correction to previously submitted hours were worked 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 ______________
LL 06-2016
