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Employee Information

Name: Address: Phone: SS #: Dept.: Position: Hire Date:

2012 ABSENTEE CALENDAR

Absent Codes

T - Tardy H - Holiday L - Layoff P - Partial Hours Worked V - Vacation O - Other: _________________ _________________ _________________ _________________ 1 - Lack of Work 2 - Sick (Employee) 3 - Family Sickness 4 - Accident (off the Job) 5 - Workers' Comp. 6 - Personal 7 - Discipline 8 - Leave of Absence 9 - Transportation 10 - Unknown 11 - Death in Family 12 - Jury Duty/Court 13 - Military 14 - Weather 15 - Medical Appointment 16 - Recognition 17 - FMLA 18 - _____________ 19 - _____________ 20 - _____________

_______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________ _______________________________________________

Vacation Hours Available: _____________________________________

JANUARY

S M

1 8 15 22 29 2 9 16 23 30

T

3 10 17 24 31

W

4 11 18 25

T

5 12 19 26

F

6 13 20 27

S

7 14 21 28

FEBRUARY

S M T

2012 CALENDAR

W

1

T

2 9 16 23

F

3 10 17 24

S

4 11 18 25

MARCH

S M

T

W

T

1

F

2 9 16 23 30

S

3 10 17 24 31

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

APRIL

S

1 8 15 22 29

M

2 9 16 23 30

T

3 10 17 24

W

4 11 18 25

T

5 12 19 26

F

6 13 20 27

S

7 14 21 28

MAY

S

M

T

1

W

2 9 16 23 30

T

3 10 17 24 31

F

4 11 18 25

S

5 12 19 26

JUNE

S

M

T

W

T

F

1

S

2 9 16 23 30

6 13 20 27

7 14 21 28

8 15 22 29

3 10 17 24

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

JULY

S

1 8 15 22 29

M

2 9 16 23 30

T

3 10 17 24 31

W

4 11 18 25

T

5 12 19 26

F

6 13 20 27

S

7 14 21 28

AUGUST

S M

T

W

1

T

2 9 16 23 30

F

3 10 17 24 31

S

4 11 18 25

SEPTEMBER

S M T

W

T

F

S

1

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

2 9 16 23 30

3 10 17 24

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

OCTOBER

S M

1 7 14 21 28 8 15 22 29

T

2 9 16 23 30

W

3 10 17 24 31

T

4 11 18 25

F

5 12 19 26

S

6 13 20 27

NOVEMBER

S M T

W

T

1

F

2 9 16 23 30

S

3 10 17 24

DECEMBER

S M T

W

T

F

S

1

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

2 9 16 23 30

3 10 17 24 31

4 11 18 25

5 12 19 26

6 13 20 27

7 14 21 28

8 15 22 29

revised 12/11

BI-MONTHLY ABSENCE REVIEW

Soc. Sec. # Emp. Start Date

Employee Name

Review Period (Two Weeks)

Absences This Review Period : (month/year) Total Days Occurrences Absent Stated Reason/Explanation

Action Taken

Note: Payroll records, including records of absences, should be retained for at least six years.

revised 12/11

Provided as a courtesy of The Ohio Manufacturers' Association (OMA). For more information about this, and other OMA services, call 1-800-662-4463 or visit ohiomfg.com.

The Ohio Manufacturers'

Information

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