Non-Teaching Instructional Staff
Office Service Record
                                                                                  For the Month of:_________________
 

 
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10
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15
16
Sick Leave                                
Annual Leave                                
 
 
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20
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22
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Total Hours
Sick Leave                                
Annual Leave                                

For each day of the month, if working less than your scheduled hours, or taking time off, please enter the appropriate code from those listed below to indicate how the time off should be charged.  Enter the code & hours in the boxes provided above.
 

JD - Jury Duty 
M - Military Leave
B - Bereavement Leave
UH- Unscheduled Holiday
Employee's Certification: I certify that the entries on this record accurately and completely reflect my service to John Jay College during the stated period.

_____________________________                __________________________               ________________
          Name (please print)                                            Signature                                            Date

Supervisor's Certification: I certify that the employee was in full attendance in accordance with the administrative calendar, except as noted above.

_____________________________                __________________________               ________________
         Name (please print)                                            Signature                                            Date

Note: (Cards must be forwarded to the Human Resources Office by the 10th day of the following month)