Time and Attendance Record
Name: SSN:
U.S. Department of Housing and Urban Development
PayPeriod Yr/Num: PayPeriod Dates: Work Schedule:
Type of Hours entry code Week 1 01 02 03 04 05 06 07 Sun Mon Tue Wed Thurs Fri Sat
CWS (hrs.)
Regular Time 01
Annual Leave 61
Restored Annual 63
Sick Leave 62
Family Leave 6262
Credit Hrs CompTime Holiday Used Used Worked 50 64 31
OverTime 21
Excused Absence 66
Military Leave 65
CreditHrs. CompTime Leave Earned Earned w/o Pay 29 32 71
Work Schedule Variance(s)
Total Week 1 08 09 10 11 12 13 14 Sun Mon Tue Wed Thurs Fri Sat
Total Week 2
Certification that recorded T&A data is correct and accurate:
Employee's Signature: Timekeeper's Signature: Supervisor's Signature:
Brought Forward Accrued (earned this pay period)
Leave Record
Total Available Used this Pay Period Balance to Date
Current T&A Update:
Status Chage: Start _______ / End _______
X Remarks:
X
X
Annual (61) Restored Annual Leave (63) Year 1 Year 2
Adv. Leave Code: ________________ Oath of Office: __________________ Final T&A: ______________________
PRE
TC
SUFF
Totals Week 1 Week 2
Accounting Data A B
LL
Credit Hrs. (50) Sick (62) Compensatory (64) LWOP (71) AWOL (72)
AUO 1st Wk. ______ 2nd Wk. ________ Acct. data Code: _________________ Corrected T&A: __________________ Work Schedule Code: _____________ Master Record Update:
Total Pay Hrs.
Suspension (73) Military days (65) Furlough (74) No.of Days
Contact Point No. 83-
Total NonPay Hrs:
Previous ediitions are obsolete
form HUD-25012 (5/98)