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NAME BLOCK SICK ANNUAL HOURS OF DUTY IF N/D Reporting Unit OR OTHER THAN REGULAR Leave balances brought forward from prior period Agency Leave accrued during this reporting period Pay Period No. may 30 June TOTAL HOURS / V Aggregate of leave available during this period TIME AND ATTENDANCE TIME WORKED TIME ABSENT DATE INITIALS* REPORT COMPEN- COMPEN- IN OUT REGULAR N/D O/T AWOL LWOP SICK ANNUAL OTHER Standard Form No. 1130 SATORY SATORY (General Regulations No. 102-Rev.) - Form prescribed by Comp. Gen., U.S. Sun. May 17, 1946 Mon. Holiday REMARKS Tue. 8 Wed. 8g Thu. Fri. 8 4 Sat. 8 XXX XXX FIRST WEEK TOTAL Sun. 8 Mon. 8 4 Tue. 8 4 TRUMAN 8 it Wed. S. NARA LIBRARY Thu. 8 4 MARA Fri. 8 4 Sat. 8 XXX XXX SECOND WEEK TOTAL PAY PERIOD TOTAL COMPENSATORY TIME Brought forward XXX Tel. Balances at close of this period Worked this pay period W. O. P. total for calendar year to end of prior period Certified correct Total for this pay period W. O. P. total for calendar year to end of this period Used this pay period *Certification for SICK LEAVE. Paid this pay period I certify that this absence was due to illness which incapacitated me for duty. 16-46691-2 GPO (Supervisor or timekeeper) Balance at end of this pay period.

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