Attendance Control Form
Employee ________________
Job _____________________
Dept _______________
I request absence from work on the day (dates) shown below:
Absent From ______________
returning On _______________
Reason for absence
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
___________________________________
Employee Signature
___________________________________
Date
General information, not legal advice. Treat this as a drafting starting point, not a finished policy — employment law varies by jurisdiction and changes often, so have a licensed attorney tailor it to your situation before you rely on it.
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