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Name: ______________________________________ Department: ______________________________ G #: ________________________________________ Organization #: ____________________________ Position #:_____________ Suffix: ________________ Time Sheet Period: __________________________ Documentation of leave use for the fiscal year must be on file with Payroll to support any unused leave days carried forward or paid out upon separation. Leave Categories Number of Hours Used Date Annual Leave Traditional Sick Leave VSDP Family & Personal Leave VSDP Sick Leave VSDP – Short Term Disability Leave Other: (Note: you are eligible for either traditional sick leave or for VSDP Family and Personal Leave, not both. If you are unsure of your status, please contact HR & Payroll) Please note: Payout of unused annual leave upon termination will be in accordance with contract provisions. Payment of sick leave upon termination is not authorized. Twenty-four days of annual leave are accrued per fiscal year. Twenty-one days may be carried forward form one fiscal year to the next. Thirty-six days is the maximum accumulation. Annual leave is pro-rated for periods of employment of less than one year at the rate of two days per month worked. Part-time employees have proportionate accrual maximums. Upon separation, leave payout is based on leave earned, not leave granted. I certify that the time sheet I am submitting correctly and accurately reflects leave taken during this time period. Signature: _________________________________ Approved By: _____________________________________ Date: ______________ Printed Name: _________________________________ Printed Name: _____________________________________ Human Resources & Payroll 4400 University Drive, MS 3C3, Fairfax, Virginia 22030 Phone: 703-993-2600; Fax: 703-993-2601 Amended Leave Report: Instructional, Research & Administrative/Professional Faculty 7/7/2014

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Page 1: Human Resources & Payroll 4400 University Drive, MS 3C3 ...hr.gmu.edu/forms_standard/payroll/AmendedLeaveReportInstructional.pdfDocumentation of leave use for the fiscal year must

Name: ______________________________________ Department: ______________________________ G #: ________________________________________ Organization #: ____________________________ Position #:_____________ Suffix: ________________ Time Sheet Period: __________________________ Documentation of leave use for the fiscal year must be on file with Payroll to support any unused leave days carried forward or paid out upon separation. Leave Categories Number of Hours Used Date Annual Leave Traditional Sick Leave

VSDP Family & Personal Leave VSDP Sick Leave VSDP – Short Term Disability Leave Other:

(Note: you are eligible for either traditional sick leave or for VSDP Family and Personal Leave, not both. If you are unsure of your status, please contact HR & Payroll)

Please note: Payout of unused annual leave upon termination will be in accordance with contract provisions. Payment of sick leave upon termination is not authorized. Twenty-four days of annual leave are accrued per fiscal year. Twenty-one days may be carried forward form one fiscal year to the next. Thirty-six days is the maximum accumulation. Annual leave is pro-rated for periods of employment of less than one year at the rate of two days per month worked. Part-time employees have proportionate accrual maximums. Upon separation, leave payout is based on leave earned, not leave granted. I certify that the time sheet I am submitting correctly and accurately reflects leave taken during this time period. Signature: _________________________________ Approved By: _____________________________________ Date: ______________ Printed Name: _________________________________ Printed Name: _____________________________________

Human Resources & Payroll 4400 University Drive, MS 3C3, Fairfax, Virginia 22030 Phone: 703-993-2600; Fax: 703-993-2601

Amended Leave Report: Instructional, Research & Administrative/Professional Faculty

7/7/2014

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