Absence Management: mm/dd/yyyy - mm/dd/yyyy

mm/dd/yyyy - mm/dd/yyyy [insert Pay Code] Hours: 00:00
Source comments go here. Work Days Missed: [insert #]
mm/dd/yyyy - mm/dd/yyyy [insert Pay Code] Hours: 00:00
Source comments go here. Work Days Missed: [insert #]
  FMLA: 020

Chargeable: System, Occurence Number: 5

Is chargeable:

*Change Notes: (255 character limit)

Sign-Off Milestone

Signature(s) needed from:

  • [insert employee name/badge #]
  • [insert manager name]

Counseling Milestone

Reason for Counseling: Absenteeism Record

Chargeable Absence Dates:

# DATE(S) PAY CODE
6 07/06/2016 - 07/07/2016 1024 - Sick
5 07/01/2016 1024 - Sick
4 06/28/2016 2029 - Request Off Chargeable
3 06/27/2016 2006 - No Show
2 06/20/2016 2005 - Late for Work
1 06/13/2016 2005 - Late for Work

* Describe events or behavior leading to this counseling:

Action Plan:
* 1. What are the consequences if performance does not improve?

* 2. Describe the actions employee will take to improve performance.

* Required

Final Record of Warning Milestone

Reason for Warning: Absenteeism Record

Chargeable Absence Dates:

# DATE(S) PAY CODE
10 08/30/2016 2006 - No Show
9 08/29/2016 2006 - No Show
8 08/28/2016 2006 - No Show
7 08/01/2016 - 08/03/2016 1024 - Sick
6 07/06/2016 - 07/07/2016 1024 - Sick
5 07/01/2016 1024 - Sick
4 06/28/2016 2029 - Request Off Chargeable
3 06/27/2016 2006 - No Show
2 06/20/2016 2005 - Late for Work
1 06/13/2016 2005 - Late for Work

* Describe events or behavior leading to this warning:

Action Plan:
* 1. What are the consequences if performance does not improve?

* 2. Describe the actions employee will take to improve performance.

* Required