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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