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Warning Text: Warning Text XTableStyleMedium9PivotStyleLight16`B December 2026  ;75fFf0! @ZR]3 A@@   y?DayDate Hours WorkedVacationSickSunMonWedThuFriSat/Administrative Leave (includes campus closings) Injury LeaveMilitary LeaveUnpaid Leave of AbsenceWCWorkers CompensationEmployee SignatureHolidaySupervisor SignatureJury Duty or Civil LeaveOther Leave Hours TuesTue Department:Total Leave UsedADMHOLINJJRCVMILUNPL *Reason Code*Code Funeral Leave Description 2Comp Time will autocalculate; do not override the Total HrsFNLEmployee Name:&Employee Personnel Number (6 digits): Reporting Period (Month/Year):Comp Time Used$Directions: 1. Record total hours worked each day, for ALL days listed 2. Record vacation, sick or comp time used in appropriate column 3. Record other leave hours and designate reason code (below)RComp Time Earned WeekComp Time EarnedL4. Have supervisor sign and turn in to HR by the 10th of the following month Comp Earned'as effective and valid as the original.PBy submitting this form electronically, I recognize that it will be considered NS Not ScheduledFMLA@*Family Medical Leave (unpaid - available only with HR approval).formula or entries in Comp Time Earned column.- December 2026rev 06/03/20260 FMLA will be unpaid. See HR for more details.G Paid leave must be used during FMLA. If no paid leave is available, 4 Compensatory Time FLSA Non-Exempt Professional and Support Staff employees are eligible to earn comp time with supervisory approval at the rate of 1.5 for hours worked over forty (40) per week (Sunday - Saturday). The use of leave time (vacation, sick, holiday, comp time, admin, etc) is not considered hours worked and those hours are excluded from comp time calculations. For more information about compensatory time: Support Staff - reference Article 7 of the 2025-27 NAPE Agreement, Board Policy 5104 or Board Policy 5032. Professional Staff - reference Section 6.3 of the 2025-27 NSCPA Agreement, Board Policy 5103 or Board Policy 5032. ;T  I*Note: Also mark vacation, sick or comp time in conjunction with FMLA. ]CHADRON STATE COLLEGE MONTHLY WORK/LEAVE REPORT FLSA NON-EXEMPT EMPLOYEES ON MONTHLY PAYROLLB 8 J8L8T9V9:!:<<[=]ccB ZO IXMhMv;x  dMbP?_*+%&C&"Arial,Bold Italic"&16 &{Gz?'Q?()M.Microsoft Print to PDFP/ odXXLetterGIS4DINU"$,?]{~ SMTJ{084F01FA-E634-4D77-83EE-074817C03581}RESDLLUniresDLLPaperSizeLETTEROrientationPORTRAITResolutionResOption1ColorModeColor,V4DM p"O4wMH5L*@VDocumentUserPasswordDocumentOwnerPasswordDocumentCryptSecurity"dXX&U} } I} } } I} } } ^} } } } m} I } "} $ I@@@@@@J@<@A A @ @ @ @@@@@@@@@@@@@@@@@@@ >$_&_&JJJJJJJJ]JJJJJJJ ("    )  *   8B4@N!% (?B O P P P P P+ P W! i. 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