MonthlyEmployees’LeaveAdjustments
DepartmentName
ReportingMonth Year 
Employee
ADPID#
Name
ExplanationofAdjustment
Beveryspecificregardingdates,numberofhours,and
typeofleave(sick,vacation,etc.)
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Supervisor’sSignature
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Date
Monthly employees are required to record their annual & sick leave
electronicallybythe20
th
ofeachmonth.Leaveafterthe20
th
shouldbe
projected.The Monthly Employees’ Leave Adjustments report is for
changes to projected leave as well as any other leave adjustments.
PleasesubmittoHRbythe firstFriday inthefollowingmonth, evenif
thereare noad
j
ustmentstore
p
ort.