Timesheet 164 by mrleitner

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									UNIVERSITY OF CALIFORNIA RIVERSIDE

TIME RECORD
UPAY 100R (R05/95)

NAME DEPT.

EMP. ID PAY SCHEDULE

MONTH/YEAR PREMIUM OVERTIME STATUS

ELIG 1 DAY OF MO 2 3 HOURS WORKED BY FUND SOURCE 4 TOTAL HOURS WORKED 5
OVERTIME REGULAR

NOT ELIGIBLE

6
OVER-

7 8 9 OVERTIME / LEAVE TIME HOURS
VACATION LEAVE SICK LEAVE COM TIME OFF

10
LEAVE

11
OTHER LEAVE NOTE TYPE

TIME PREMIUM

WITHOUT PAY

DEPARTMENTAL USE DESCRIPTION OF SERVICE CODES (DOS)

REG OTP OTS VAC SKL CTO PTO 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
T O T A L TRIP COMP TIME SICK LEAVE

= = = = = = = = = = = = =

Regular Time Overtime Premium Overtime Straight Vacation Taken Sick Leave Taken Comp Time Taken Trip Bonus Leave Taken Vacation Accrued Sick Leave Accrued Comp Time Accrued Comp Time Paid Terminal Vacation Paid Terminal Trip Bonus Paid OTHER LEAVE TYPES

VLA SLA CTA CMP TRM PTT

F M D FM N J E H O

= = = = = = = = =

Family Sick Leave Military Leave Death in Family Leave Family Medical Leave Leave Without Pay Jury Duty Election Voting Time Holiday Leave Other

REG BALANCE
VACATION

EARNED

TAKEN

END BALANCE

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

MAX VAC LIMIT

MAX VAC EARNED/MO APPROVAL(S)

MAX SICK LV EARNED/MO

I CERTIFY THE ABOVE TIME IS CORRECT

EMPLOYEE SIGNATURE

INSTRUCTION ON REVERSE SIDE

RETENTION PERIOD 5 YEARS


								
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