Employee Absence Report and Summary

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					[COMPANY NAME] Employee Absence Report
Date: ______________________________ Report completed by Name: Title: Phone No: (



EMPLOYEE INFORMATION Full Name: Employee ID:  Male  Female Street Address: City: Job Description/Title: Supervisor: Department: State: Apt: Zip Code: Hire Date: Birth Date:

DESCRIPTION OF ABSENCE(S) Date(s) of absence: Absence was:  with pay  without pay Reason for absence:         Sick Leave (self) Sick Leave (family illness) Jury Duty (attach copy of summons) Bereavement Leave Holiday Vacation Personal Leave Other

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Description: Employees are some of the most valuable resources a company has, and can contribute substantially to the success of a business. Absenteeism can cost a company in many ways, both direct and indirect, and it may be difficult to understand the scope of these costs without a clear written record of the absences. In some cases, an organization may be required to permit absences based on local or federal law, and to supply information about the length and type of such leaves. Employees may need this information to qualify for medical expense reimbursement and other benefits. The enclosed forms can provide an ongoing record of absences, benefiting both the company and its employees.
This document is also part of a package Hiring and Managing Employees 28 Documents Included