
Occur. #
| Hire Date: | mm/dd/yyyy | |
| Hours Worked: | hhhh : mm | |
| Remaining FMLA Hours: | hhh |
| Has worked 12 months? | ||
|---|---|---|
| Hire Date: | mm/dd/yyyy | |
| Years Employeed: | # | |
| Has worked 1250 hours? | ||
| Hours Worked: | hhhh : mm | |
| Has available FMLA hours? | ||
| FMLA Used: | hhh | |
| Remaining: | hhh | |
| Undesignated: | hh : mm | |