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									                                                    LEAVE SUMMARY
                                                 For Overtime-Ineligible Employees
                                                                                                               DUE BY NOON ON:                                INSTRUCTIONS
                                                 NAME: First & Last Name - will carry forward
                                                                                                                                           1)   When working a regular workday, use the right-
                       DAY MY WORK WEEK BEGINS: SUNDAY                                                              6/4/2009                    hand box to denote "W" for days worked. If you
                                                                                                                                                have a 100% FTE, the boxes will automatically
                      TIME MY WORK WEEK BEGINS: 12:00 AM                                                                                        enter W for all work days. These can be changed
                                                                                                                                                for leave or alternate schedules.
                                 MY FTE: Put your FTE% here (50-100) - will carry forward
HAS YOUR FTE CHANGED DURING THIS MONTH? Answer this question                                                     2) When taking leave, denote the number of hours of
                                         If your FTE is not entered correctly, an error message will appear here    leave taken in the right-hand box and the type of
                                                                                                                                                leave taken in the left-hand box.
         SAMPLE MONTH 2011
      Sunday              Monday             Tuesday            Wednesday           Thursday               Friday        Saturday          3)   When combining work and leave on a single day,
                                                                                                                                                denote on separate lines the number of hours
                                                        1                   2                     3                 4                5          worked and the number of hours of leave taken.
                                         W                  W                   W                      W
                                                                                                                                           4)   Use the following leave codes in the left-hand
                                                                                                                                                box: (Note: use separate lines for time worked and
                                                                                                                                                leave in a single day.)


                  6                 7                    8                  9                    10                 11               12         A    Annual Leave (Vacation) Used - incl approval
                    Only leave a day S                 4.5 W                    W                      W                                        B    Bereavement Leave - only available for death of family member
                    blank if you did W                 3.5                                                                                      C    Civil Leave (e.g. Jury Duty- include summons)
                    not work or have                                                                                                            D    Discretionary Leave Used - incl. approval
                    leave that day                                                                                                              F    FMLA / FC - Covered Leave - must have plan approved by HR
                 13               14                   15               16                       17                 18               19         HC Holiday Credit Earned
                    W                 W                     W                   W                      W                                        HU Holiday Credit Used
                                                                                                                                                M    Military Leave
                                                                                                                                                L    Leave Without Pay
                                                                                                                                                O    Other situation--explain in the NOTES section below
                 20                21                  22               23                       24                 25               26         PH Personal Holiday taken
                      W                  W                  W                   W                      W                                        S    Sick Leave Used
                                                                                                                                                W    Worked


                                                                                                                                           5)   University-wide holidays are automatically entered
                                                                                                                                                on the schedule with hours based on the FTE
                 27                28                  29               30                       31                                             entered at the top. Holidays are indicated in yellow
                      H             8 PH                8 A              8 W                                                                    with the "H" code in the right-hand cell. If
                      Hours for a                                                                                                               combining work and holiday or leave and holiday on
                      holiday are a                                                                                                             a single day, denote on separate lines the number
                      formula based on                                                                                                          of hours of holiday and number of hours worked or
                                                                                                                                                leave taken.
                      FTE.
                                                                                                                                           6)   If you did not take leave during the month, indicate
                                                                                                                                                "W" on your regular workdays and check the box in
      NOTES                                                                                                                                     the NOTES section below to certify that no leave
                                                                                                                                                was taken.

    By checking here, I certify that I have not taken any leave this month.                                                                7)   Write other comments in the NOTES section as
                                                                                                                                                needed.
 When checking this box, work days still need to be entered. This is not a substitute for filling out the calendar.
                                                                                                                                           8)   Print the completed Leave Summary. Attach hard
                                                                                                                                                copies of the back-up documentation that shows
                                                                                                                                                your supervisor approved the leave that was taken.
                                                                                                                                                Approval needs to be in writing and includes: dates
                                                                                                                                                of leave, type of leave, number of hours of leave
                                                                                                                                                per day.
                                                                                                                                           9)   Give the signed Summary and attachments to your
                                                                                                                                                supervisor by the due date (in red at the top of
                                                                                                                                                each month). The packet needs to be signed by
                                                                                                                                                your supervisor and given to your leave coordinator
 I certify this record is complete and accurate by signing below.               I approve this summary, including leave noted (approvals   attached). or she can enter on OWLS.
                                                                                                                                                so she

                                                                                    Supervisor's signature is not a substitute for         10) You can review your leave use, accrual, and
                                                                                       including necessary leave approvals                     balances on the web by logging into your Employee
 Employee signature                                             Date            Supervisor Signature                            Date           Self Service account with your UW Net ID. Point
                                                                                                                                               your browser to http://myuw.washington.edu and
                                                                                                                                               follow the link to Employee Self Service.


                                                                                                                                           11) Contact your leave coordinator with questions.
                                                    LEAVE SUMMARY
                                                For Overtime-Ineligible Employees
                                                                                                          DUE BY NOON ON:
                                  NAME:                 Enter your name here
               DAY MY WORK WEEK BEGINS:                 SUNDAY                                                2/2/2011
              TIME MY WORK WEEK BEGINS:                 12:00 AM
                                 MY FTE:                Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


 January 2011
     Sunday              Monday         Tuesday           Wednesday           Thursday               Friday        Saturday
                                                                                                                               1

                 2                  3               4                 5                     6                  7               8




                 9                 10              11               12                     13                 14              15




                16                17               18               19                     20                 21              22
                     H     Enter FTE above

                     MLK Jr. Day
                     Holiday
                23                 24              25               26                     27                 28              29




                30                 31




     NOTES


     By checking here, I confirm that I have not taken any leave this month other than holidays noted.




I certify this record is complete and accurate by signing below.          I approve this summary, including leave (approvals attached).



Employee signature                                       Date             Supervisor Signature                            Date
                                                    LEAVE SUMMARY
                                                For Overtime-Ineligible Employees
                                                                                                          DUE BY NOON ON:
                                  NAME:                 Enter your name here
               DAY MY WORK WEEK BEGINS:                 SUNDAY                                                3/2/2011
              TIME MY WORK WEEK BEGINS:                 12:00 AM
                                 MY FTE:                Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


 February 2011
     Sunday              Monday         Tuesday           Wednesday           Thursday               Friday        Saturday
                                                    1                 2                     3                  4               5




                 6                 7                8                 9                    10                 11              12




                13                14               15               16                     17                 18              19




                20               21                22               23                     24                 25              26
                     H    Enter FTE above

                   President's Day
                   Holiday
                27              28




     NOTES


     By checking here, I confirm that I have not taken any leave this month other than holiday noted.




I certify this record is complete and accurate by signing below.          I approve this summary, including leave (approvals attached).



Employee signature                                       Date             Supervisor Signature                            Date
                                                     LEAVE SUMMARY
                                                 For Overtime-Ineligible Employees
                                                                                                          DUE BY NOON ON:
                                  NAME:                 Enter your name here
               DAY MY WORK WEEK BEGINS:                 SUNDAY                                                4/4/2011
              TIME MY WORK WEEK BEGINS:                 12:00 AM
                                 MY FTE:                Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


 March 2011
     Sunday           Monday            Tuesday           Wednesday           Thursday               Friday        Saturday
                                                    1                 2                     3                  4               5




                 6                7                 8                 9                    10                 11              12




                13               14                15               16                     17                 18              19




                20               21                22               23                     24                 25              26




                27               28                29               30                     31




     NOTES


     By checking here, I confirm that I have not taken any leave this month.




I certify this record is complete and accurate by signing below.          I approve this summary, including leave (approvals attached).



Employee signature                                       Date             Supervisor Signature                            Date
                                                     LEAVE SUMMARY
                                                 For Overtime-Ineligible Employees
                                                                                                          DUE BY NOON ON:
                                  NAME:                 Enter your name here
               DAY MY WORK WEEK BEGINS:                 SUNDAY                                                5/3/2011
              TIME MY WORK WEEK BEGINS:                 12:00 AM
                                 MY FTE:                Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


 April 2011
     Sunday           Monday            Tuesday           Wednesday           Thursday               Friday        Saturday
                                                                                                               1               2




                 3                4                 5                 6                     7                  8               9




                10               11                12               13                     14                 15              16




                17               18                19               20                     21                 22              23




                24               25                26               27                     28                 29              30




     NOTES


     By checking here, I confirm that I have not taken any leave this month.




I certify this record is complete and accurate by signing below.          I approve this summary, including leave (approvals attached).



Employee signature                                       Date             Supervisor Signature                            Date
                                                       LEAVE SUMMARY
                                                  For Overtime-Ineligible Employees
                                                                                                            DUE BY NOON ON:
                                  NAME:                    Enter your name here
                DAY MY WORK WEEK BEGINS:                   SUNDAY                                                6/2/2011
               TIME MY WORK WEEK BEGINS:                   12:00 AM
                                 MY FTE:                   Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


 May 2011
     Sunday                  Monday         Tuesday          Wednesday           Thursday               Friday        Saturday
                     1                  2              3                 4                      5                 6               7




                     8                  9             10               11                     12                 13              14




                15                    16              17               18                     19                 20              21




                22                    23              24               25                     26                 27              28




                29                   30               31
                         H    Enter FTE above

                         Memorial Day
                         Holiday

     NOTES


     By checking here, I confirm that I have not taken any leave this month other than holiday noted.




I certify this record is complete and accurate by signing below.             I approve this summary, including leave (approvals attached).



Employee signature                                           Date            Supervisor Signature                            Date
                                                     LEAVE SUMMARY
                                                  For Overtime-Ineligible Employees
                                                                                                           DUE BY NOON ON:
                                  NAME:                  Enter your name here
               DAY MY WORK WEEK BEGINS:                  SUNDAY                                                7/5/2011
              TIME MY WORK WEEK BEGINS:                  12:00 AM
                                 MY FTE:                 Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


June 2011
     Sunday            Monday            Tuesday           Wednesday           Thursday               Friday        Saturday
                                                                       1                     2                  3              4




                 5                 6                 7                 8                     9                 10              11




                12               13                 14                15                    16                 17              18




                19               20                 21                22                    23                 24              25




                26               27                 28                29                    30




     NOTES

     By checking here, I confirm that I have not taken any leave this month.




I certify this record is complete and accurate by signing below.           I approve this summary, including leave (approvals attached).



Employee signature                                         Date            Supervisor Signature                             Date
                                                             LEAVE SUMMARY
                                                        For Overtime-Ineligible Employees
                                                                                                                  DUE BY NOON ON:
                                  NAME:                      Enter your name here
                DAY MY WORK WEEK BEGINS:                     SUNDAY                                                    8/2/2011
               TIME MY WORK WEEK BEGINS:                     12:00 AM
                                 MY FTE:                     Enter your FTE                              %
HAS YOUR FTE CHANGED DURING THIS MONTH?


July 2011
     Sunday              Monday               Tuesday              W ednesday         Thursday               Friday           Saturday
                                                                                                                      1                  2




                3                   4                    5                   6                    7                   8                  9
                     H      Enter FTE above

                     4th of July
                     Holiday
              10                   11                  12                   13                   14                   15                16




              17                   18                  19                   20                   21                   22                23




              24                   25                  26                   27                   28                   29                30


              31




     NOTES

      By checking here, I confirm that I have not taken any leave this month other than holiday noted.




I certify this record is complete and accurate by signing below.                  I approve this summary, including leave (approvals attached).



Employee signature                                            Date                Supervisor Signature                                Date
                                                      LEAVE SUMMARY
                                                  For Overtime-Ineligible Employees
                                                                                                           DUE BY NOON ON:
                                  NAME:                  Enter your name here
               DAY MY WORK WEEK BEGINS:                  SUNDAY                                                9/2/2011
              TIME MY WORK WEEK BEGINS:                  12:00 AM
                                 MY FTE:                 Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


August 2011
     Sunday            Monday            Tuesday           Wednesday            Thursday              Friday        Saturday
                                   1                 2                 3                     4                  5              6




                 7                 8                 9                10                    11                 12              13




                14               15                 16                17                    18                 19              20




                21               22                 23                24                    25                 26              27




                28               29                 30                31




     NOTES

      By checking here, I confirm that I have not taken any leave this month.




I certify this record is complete and accurate by signing below.           I approve this summary, including leave (approvals attached).



Employee signature                                         Date            Supervisor Signature                             Date
                                                      LEAVE SUMMARY
                                                  For Overtime-Ineligible Employees
                                                                                                           DUE BY NOON ON:
                                  NAME:                  Enter your name here
               DAY MY WORK WEEK BEGINS:                  SUNDAY                                                10/4/2011
              TIME MY WORK WEEK BEGINS:                  12:00 AM
                                 MY FTE:                 Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


September 2011
     Sunday              Monday          Tuesday           Wednesday           Thursday               Friday        Saturday
                                                                                             1                  2              3




                 4                5                  6                 7                     8                  9              10
                     H    Enter FTE above

                     Labor Day
                     Holiday
                11                12                13               14                     15                 16              17




                18                19                20               21                     22                 23              24




                25                26                27               28                     29                 30




NOTES

     By checking here, I confirm that I have not taken any leave this month other than holiday noted.




I certify this record is complete and accurate by signing below.           I approve this summary, including leave (approvals attached).



Employee signature                                         Date            Supervisor Signature                             Date
                                                      LEAVE SUMMARY
                                                   For Overtime-Ineligible Employees
                                                                                                           DUE BY NOON ON:
                                  NAME:                  Enter your name here
               DAY MY WORK WEEK BEGINS:                  SUNDAY                                                11/2/2011
              TIME MY WORK WEEK BEGINS:                  12:00 AM
                                 MY FTE:                 Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


October 2011
     Sunday            Monday            Tuesday           Wednesday           Thursday               Friday        Saturday
                                                                                                                               1

                 2                 3                 4                 5                     6                  7              8




                 9               10                 11               12                     13                 14              15




                16               17                 18               19                     20                 21              22




                23               24                 25               26                     27                 28              29




                30               31




     NOTES

     By checking here, I confirm that I have not taken any leave this month.




I certify this record is complete and accurate by signing below.           I approve this summary, including leave (approvals attached).



Employee signature                                         Date            Supervisor Signature                             Date
                                                      LEAVE SUMMARY
                                                  For Overtime-Ineligible Employees
                                                                                                           DUE BY NOON ON:
                                  NAME:                  Enter your name here
               DAY MY WORK WEEK BEGINS:                  SUNDAY                                                12/2/2011
              TIME MY WORK WEEK BEGINS:                  12:00 AM
                                 MY FTE:                 Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


November 2011
     Sunday            Monday            Tuesday           Wednesday           Thursday               Friday         Saturday
                                                     1                 2                     3                 4                5




                 6                 7                 8                 9                    10                 11               12
                                                                                                  H     Enter FTE above

                                                                                               Veteran's Day
                                                                                               Holiday
                13               14                 15               16                     17              18                  19




                20               21                 22               23                   24              25                    26
                                                                           H                 above Enter FTE above
                                                                                   Enter FTE H

                                                                           Thanksgiving           Day After Thanksgiving
                                                                           Holiday                Holiday
                27               28                 29               30




     NOTES

     By checking here, I confirm that I have not taken any leave this month other than holidays noted.




I certify this record is complete and accurate by signing below.           I approve this summary, including leave (approvals attached).



Employee signature                                         Date            Supervisor Signature                             Date
                                                     LEAVE SUMMARY
                                                 For Overtime-Ineligible Employees
                                                                                                         DUE BY NOON ON:
                                  NAME:                 Enter your name here
                DAY MY WORK WEEK BEGINS:                SUNDAY                                                 1/4/2012
               TIME MY WORK WEEK BEGINS:                12:00 AM
                                 MY FTE:                Enter your FTE                           %
HAS YOUR FTE CHANGED DURING THIS MONTH?


  December 2011
      Sunday               Monday        Tuesday         Wednesday            Thursday               Friday        Saturday
                                                                                            1                  2               3




                  4                  5              6                 7                     8                  9              10




                 11                 12             13                14                   15                  16              17




                 18                 19             20                21                   22                  23              24




                 25                26              27                28                   29                  30              31
                       H    Enter FTE above

                       Christmas
                       Holiday

      NOTES

       By checking here, I confirm that I have not taken any leave this month other than holidays noted.




  I certify this record is complete and accurate by signing below.        I approve this summary, including leave (approvals attached).



  Employee signature                                     Date             Supervisor Signature                            Date

								
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