ADMINISTRATIVE OFFICE OF COURTS
EMPLOYEE ATTENDANCE RECORD
Social Security Number:
MAJOR MEDICAL LEAVE
MAJ. MED. (DEATH IN FAMILY) RELATION:
NATURAL DIASTER LEAVE (HURRICANE, SNOW, ETC.)
MILITARY LEAVE (ORDERS ATTACHED)
CIVIL LEAVE (COURT ORDERS ATTACHED)
LEAVE WITHOUT PAY (ONLY IF LEAVE IS NOT AVAIL.)
ROUTINE HOURS WORKED
I certify these leave records to be true and correct.
(Signature of Employee)
I certify these leave records to be accurate to the best of my knowledge.
(Signature of Supervisor)
NOTE: Both rows and columns ARE REQUIRED to be totalled.
As a cross-check, the total of the first column and the bottom row (bottom left shaded total) should be the same.
Days during each month that represent week-ends should be highlighted with a marker or "X'ed" out.
Time sheets are due to the Finance Department on or before the 5th of each month.
If these forms are not received by the due date we will stop any direct deposits and hold any checks for the month.