Employee Absence Report Form

for Your State

Employee Absence Report Form will ensure that your employees absences are well-documented. This simple to use form can easily be tailored to meet your needs.

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For Immediate Download

$19.95 Add to Cart
Free eSignature included
with every order
Please select a state

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This Employee Absence Report Form will ensure that an employee's absence is clearly documented. This easy to use form includes the employee's name, date hired, job title and department in which he or she works. It also sets out if the absences are with or without pay, reason employee was not at work and any comments you wish to make regarding the absence. It is important that any absent days be clearly documented for payroll and vacation purposes. This Employee Absence Report Form is a simple but effective way to do so.

This Employee Absence Report Form includes the following:
  • Employee: Employee's name, social security number, job title, department and date of hire;
  • Absence Dates/Reasons: Sets out the date of absence, whether paid or unpaid, if an employee's absence is for a holiday, vacation, sickness or other reason.

Protect your rights by using our attorney-prepared up-to-date forms.

This attorney-prepared packet contains:
  1. General Instructions
  2. Employee Absence Report Form
State Law Compliance: This form complies with the laws of all states
Number of Pages2
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#22087
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
Employee Absence Report Form
Provided under agreement with copyright holder,
© Nova Publishing Company 2004

This is a simple form to be completed for each instance of an employees absence, whether for holiday, vacation, sickness, or otherwise. It provides a record of the reason for the absence, pay, and other comments regarding the incident.


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An attorney should be consulted for all serious legal matters.

Employee Absence Report Form

Employee name  __________________________________________
Social Security number  _________    Job title   __________________
Department  _________________    Date hired __________________

Date(s) of Absence
With pay                                                       Without pay
__________________________      ________________________
__________________________      ________________________
__________________________      ________________________

Reason for Absence
Holiday    ___________________
Vacation  ___________________
Sickness  ___________________
Other         _______________________________________________

Comments   ______________________________________________

__________________________      ________________________ Signature of Employee         Date

Approved by _________________    Date  ______________________

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