SOUTH WASHINGTON COUNTY SCHOOLS

PAYROLL VOUCHER & TIME-OFF REPORTING FORM BUILDING:

LEGAL NAME: / LAST 4 DIGITS OF SS#: / EXPLANATION OF WORK:
BARGAINING GROUP: Office Professional Teacher Maintenance Kids Club Supervisor ______
(Main/Primary job type) Office Prof Sub Teacher Sub Student/OJT Community Ed Misc CE Aquatics / RATE OF PAY:
BARGAINING GROUP: Highly Qualified Paraprofessional Paraprofessional Substitute
(Main/Primary job type) Paraprofessional / RATE OF PAY:
(MUST INCL FOR SUB) SUBBING FOR: / (MUST INCLUDE FOR SUB) REASON FOR SUB: / SUB JOB#:

DETAIL OF HOURS WORKED - This section is OPTIONAL unless required by your supervisor.

DATES
TIME IN
TIME OUT
TIME IN
TIME OUT
TOTAL HRS

SUMMARY OF HOURS WORKED OR ABSENT (Use Time Off codes from chart below) -- This section is REQUIRED

DATE / Voucher
Totals:
ABSENT CODE & HOURS ABSENT
STRAIGHT HRS
OT / OTHER HRS

Time Off reporting on vouchers is for VOUCHER-PAID employees only; time-off MUST be reported in ERMA prior to submitting on this voucher.

CODE / DESCRIPTION OF ABSENCE / CODE / DESCRIPTION OF ABSENCE / CODE / DESCRIPTION OF ABSENCE
FNR / Funeral / PIL / Personal Illness / WC / Workers Comp
PB / Personal Business/ Child Activity / DD / Doctor/Dental / HOL/FLH / Holiday/Floating
FAM / Family Illness
child<18 Child>18 Spouse Parent Other ______
# OF HRS @ ACCT CODE: / - - - - - / $
# OF HRS @ ACCT CODE: / - - - - - / $
# OF HRS @ ACCT CODE: / - - - - - / $
I certify that the information reported on this form is true and accurate, and all paid absence is in accordance with my employment contract. / /

I certify that the information reported on this form is true accurate, and authorize this voucher for payment.

Employee Signature / Date / Signature of Approval (must be on file as authorized signer) / Date

Updated 02/2012