DEPARTMENT OF CIVIL & ENVIRONMENTAL ENGINEERING ACADEMIC

MONTHLY TIME SHEET

Month Year Employee Number Name (Last, First, Middle Initial)

Appointment % Pay Rate Title Code Employee Title

HOURS WORKED
Account/Fund 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 Total

0.0
0.0

Hoilday 0.0
Sick Leave 0.0
Vacation 0.0
FMLA 0.0
Jury Duty 0.0
Comp Time Accrued 0.0
Comp Time Off 0.0
OvertimeTime 0.0
TOTAL 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Accountants Approval Monthly Hours/ % Pay total hours

RECAP FROM PREVIOUS MONTH (ONLY IF THERE ARE CHANGES) MONTH:

Account/Fund 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 TOTAL

0.0
0.0

0.0
PRIVACY NOTIFICATION: The California Information Practices Act requires
SIGNATURES ABSENCE AND OVERTIME CODES
the University to provide the following information to individuals who are V = Vacation,
asked to supply information about themselves. The principal purpose for
requesting the information on this form is for payment of earnings and for
S = Sick Leave
maintenance of leave records pursuant to Section 9, Article IX of the State H = Holiday,
I certify that the hours reported above are correct. J = Jury Duty
Constitution of California. Furnishing hours worked and hours on leave by
account fund as requested on this leave is mandatory - failure to provide such FS = Family Sick
information will delay or may even prevent payment of earnings. Information OT = Overtime worked
furnished on this form may be used by various University departments in the Employee Signature ________________________________________ Date ______________ CTA=Comp Time Accrued
regular course of business and may be transmitted to the State and Federal
governments if required by law. You have the right to review personal CTO = Comp Time Off
information about yourself in accordance with Staff Personnel Policy 605 and AW = Absent without pay
Academic Personnel Manual Section 195. Your department official is Supervisor Signature ________________________________________ Date ______________
responsible for maintaining the information contained on this form.

Supervisor Signature ________________________________________ Date ______________

Privacy Notification The California Information Practices Act requres the University to provide the following information to indivi

SIGNATURES

ABSENCE AND OVERTIME CODES

owing information to individuals who are asked to supply information about themselves. The principal purpose for requesting the information
requesting the information on this form is for payment of earnings and for maintenance of leave records pursuant to Section 9, Article IX of

I certify that the hours reporte

to Section 9, Article IX of the State Constitution of California. Furnishing hours worked and hours on leave by account fund as requested on

rtify that the hours reported above are correct. Employee Sign

V = Vacation S = Sick Leave

ount fund as requested on this leave is mandatory - failure to provide such information will delay or may even prevent payment of earnings.

Employee Signature _________________________________________ Date ____________

S = Sick Leave H = Holiday J = Jury Duty

ent payment of earnings. Information furnished on this form may be used by various University departments in the regular course of busine

= Jury Duty FS = Family Sick OT = Overtime worked (must be pre

e regular course of business and may be transmitted to the State and Federal governments if required by law. You have the right to review

time worked (must be preapproved by Supervisor & MSO) CTA = Comp Time
u have the right to review personal information about yourself in accordance with Staff Personnel Policy 605 and Academic Personnel Manu

Supervisor Approval _______

CTO = Comp Time Off AW = Absent without pay

cademic Personnel Manual Section 195. Your department official is responsible for maintaining the infoprmation contained on this form.

rvisor Approval _________________________________________ Date ____________

contained on this form.
Supervisor Approval _________________________________________ Date ____________
ate ____________