NAME:
DEPARTMENT:
SOCIAL SECURITY NUMBER: - -
POSITION NUMBER: (AGENCY UNIT CLASS SERIAL):
TIME BASE: Full-TimePart-Time% WORK SHIFT: REGULAR: Monday-Friday, 8:00 a.m. to 5:00 p.m. OTHER: PLEASE INDICATE THE NUMBER OF HOURS THE EMPLOYEE IS TO BE DOCKED BY WRITING THE NUMBER OF HOURS IN THE BOX THAT CORRESPONDS TO THE DAY(S) THE DOCK OCCURRED. 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 # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr # hr REASON FOR ABSENCE: TOTAL DOCK: (as indicated above) # OF DAYS # OF HOURS CERTIFICATION: Prepared by: Approved by: NOTE: This Dock Notice must be submitted to Human Resources, Payroll Division, AD 252 immediately for any absences that will result in a dock. Corresponding entries of "L" and the number of hours of dock should be inserted on the Attendance Report (Form #672). Questions regarding this dock notice, call your Payroll Specialist or Human Resources, Information Desk, ext. 81873. CC: Employee/Attendance Clerk
WORK SHIFT: REGULAR: Monday-Friday, 8:00 a.m. to 5:00 p.m. OTHER:
PLEASE INDICATE THE NUMBER OF HOURS THE EMPLOYEE IS TO BE DOCKED BY WRITING THE NUMBER OF HOURS IN THE BOX THAT CORRESPONDS TO THE DAY(S) THE DOCK OCCURRED.
hr
REASON FOR ABSENCE:
Approved by:
NOTE: This Dock Notice must be submitted to Human Resources, Payroll Division, AD 252 immediately for any absences that will result in a dock. Corresponding entries of "L" and the number of hours of dock should be inserted on the Attendance Report (Form #672). Questions regarding this dock notice, call your Payroll Specialist or Human Resources, Information Desk, ext. 81873. CC: Employee/Attendance Clerk
