Leave Reporting Form This form allows for 23 days. If you require additional days, please attach an additional form. DEPARTMENT NAME DEPT ID Person ID: Surname: First Name: Employee Status: Full Time Part Time Hours Worked Per Week Fund Source: Trust Operating Month Date VACATION 800 816 SPECIAL LEAVE 820 822 825 827 830 832 835 837 CASUAL/GENERAL ILLNESS A medical note is required for all absences due to illness greater than 3 days 855 865 880 Other COMMENTS SIGNATURES: Authorization Signature: Phone #: Printed Name: Date: yyyy/mm/dd If this is charged to a research project/trust account, I certify that all expenditures charged to my research project/trust account are for purposes for which the grant/donation was awarded. These expenditures comply with the sponsor spending/donor terms guidelines/restrictions and, (where applicable) the expenditures conform to the budget submitted to the sponsor. These expenditures are in support of the research project/trust account named in the award/donation and there is supporting documentation to satisfy the relevance to research requirement. The personal information on this form is collected for the purpose of managing personnel under the Employment Standards Code, Section 14(4) and in accordance with the Alberta Freedom of Information and Protection of Privacy Act, Section 33c. Certain personal information will be made available to federal and provincial departments and agencies under appropriate legislative authority. For further information regarding the collection of the personal information, contact the Human Resource Services, 2-60 University Terrace, University of Alberta. Phone: 492-4555. DISTRIBUTION: Original: Human Resource Services Copy: Department Contact Human Resource Services for help on completing this form: 492-4555 March 11, 2009 Human Resource Services Leave Reporting Instructions The leave reporting form is used for reporting Support Staff absences in accordance with the Collective Agreement. The following is being provided to assist you in assuring the absence is coded properly: For each type of Leave, enter the month and day. The form allows for 23 days. Vacation (accrual based on fiscal year) Code 800 - Vacation - do not report hours for statutory holidays or regular scheduled rest days. Code 816 - Anniversary Day Off - maximum 1 time day off after completion of 25 years of service. Consult the Collective Agreement: Operating - Article 24 Annual Vacation Leave / Trust - Article 13 Vacation Special Leave - Operating (renews on fiscal year) Code 820 - Birth or Adoption - maximum 1 day to attend birth or adoption proceedings of employee's child. Code 822 - Bereavement - maximum 1 day to attend the funeral of a friend, aunt, uncle, cousin Code 825 - Citizenship Hearing - maximum 1 day to attend formal Canadian Citizenship Hearing to become a Canadian citizen Code 827 - Change of Domicile - maximum 1 moving day per fiscal year (Change of Address must be submitted) Code 830 - Compassionate Leave - maximum 3 days to attend the funeral of immediate family members, additional two days may be granted for travel Code 832 - Family Illness - maximum 2 days per episode will be allowed for sudden or serious illness within the immediate family Code 835 - Emergency or Disaster Conditions - maximum 1 day will be allowed for emergencies demanding the employee's immediate attention Code 837 - Witness or Jury Duty - Unlimited leave with pay when required by law to serve jury duty (must supply document requesting appearance) Special Leave - Trust (renews on fiscal year) Code 830 - Compassionate Leave - maximum 5 days may be granted for compassionate reasons (additional 5 days at the discretion of the Trustholder) Consult the Collective Agreement: Operating - Article 27 Special Leave, Article 28 Witness or Jury Duty / Trust - Article 15 Compassionate Leave Casual/General Illness (renews on employee's service date) Code 855 - Casual Illness - Consecutive absence of 3 days or less for which a medical note is not required Code 865 - General Illness - Consecutive absence of greater than 3 days duration, for which a medical note must be provided Proof of illness - Article 17.10 - Operating / Article 9.10 - Trust Illness and Proof of iIlness: Consult the Collective Agreement: Operating - Article 17 / Trust - Article 9 If you require additional information regarding the coding of absences, please contact Terms & Conditions at 492-4555.
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