ABSENCE NOTICE EMPLOYEE S NAME PERIOD OF ABSENCE a m

ABSENCE NOTICE EMPLOYEE’S NAME: PERIOD OF ABSENCE: a.m. From: p.m. time CHARGE TO: Vacation ................................................................................................ Sick Leave ........ Family Care ........ Family Death .............. to: date time a.m. p.m. date # HOURS Leave Without Pay .............................................................................. Compensatory Time Off ...................................................................... REASON (for item checked above): Employee’s signature D1371 (7/79) CALCODE 71461-107 Department approval signature Absence Slip.doc