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OCR Page 1 of 5NAME
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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