| A T T E N T I O N The Statement below is an Adobe Acrobat file and will not print reliably using the PRINT button on your browser. You must CLICK HERE to print a legible Statement using Adobe Acrobat Reader. |
| Name | Your name will be displayed here. If '0' is displayed, then go the Standard Information Sheet and enter your name in the 'Enter Your Name' field. | |
| Date of Hire | Your date of hire will be displayed here. If '0-Jan-1900' is displayed, then go to the Standard Information Sheet and enter your date of hire in the 'Date of Hire' field. | |
| Regular Work Week | Your regular work week schedule will be displayed here. If 'ERROR in work Schedule' is displayed, then go to the Standard Information Sheet and put a Y next to the schedule of hours you primarly work OR enter a schedule in the 'Other - Please Enter the schedule below' field. | |
| Regular Lunch Period | Your lunch period will be displayed here. If '0' is displayed, then go to the Standard Information Sheet and enter your lunch period in the 'Lunch Period' field. | |
| Timesheet Org. (TSORG) | This is the 6-digit number that reflects your department name. It's a Banner attribute assigned on the NBAJOBS record that associates an employee with a department or organization for the purposes of facilitating payroll processes. (If you don't know your Timesheet Org., you can get it from your BSC Contact). NOTE: Completion of this field will not be mandatory until recording of time and leave in Banner begins. | |
| Position - Suffix | A two character code that provides uniqueness of a specific appointment for the individual and position number. Example: the first occurrence will set the suffix to 00, the second to 01, etc. (If you don't know your Position - Suffix, you can get it from your BSC Contact). NOTE: Completion of this field will not be mandatory until recording of time and leave in Banner begins. | |
| Pay Period Ended | This is the ending date of the pay period. This date is automatically calculated. | |
| Pay Period # | Pay period number is automatically calculated based on the pay period end date. | |
| Dept | Your department will be displayed here. If '0' is displayed, then go to the Standard Information Sheet and enter your department in the 'Department' field. | |
| Phone | Your phone number will be displayed here. If '0' is displayed, then go to the Standard Information Sheet and enter your phone number in the 'Your Phone number' field. | |
| Place a Y in this box if you worked your normal expected hours & sign below | If you worked the exact schedule that appears in the Regular Work Week field (see Step 3), then you can put a Y in this box, sign the form (Step 52) and turn it into your supervisor. Since you worked your normal expected hours, you do not need to account for your time as in Steps 12 through 51 since all of these fields will be calculated against your normal expected hours by default. | |
| Actual Hours Worked (A) | If you deviated from your normal expected hours, then enter the total hours you worked each day rounded to the nearest quarter hour (.25). | |
| Normal Expected Hours (B) | Your normal expected hours per day is calculated based on your regular work week in Step 3. | |
| Actual Over (Under) Expected [(A)-(B)=(C)] | If the actual hours over/under each day is zero, then proceed to step 52. Otherwise you need to account for the hours over/under each day in Steps 15 through 22. | |
| Add Additional Time Worked (D) | Enter all additional hours worked here, rounded to quarter of hours (.25). | |
| Add Comp Time at Straight Time (F) | Enter the hours of comp time earned at straight time here rounded to quarter of hours (.25). | |
| Add Comp Time at Premium Time (G) | Enter the hours of comp time earned at premium time here rounded to quarter of hours (.25). | |
| Subtract Comp Time Taken (H) | Enter the hours of comp time taken here rounded to quarter of hours (.25). | |
| Subtract Earned Time Taken (I) | Enter the hours of earned time taken here rounded to quarter of hours (.25). | |
| Subtract Sick Pool Time Taken (J) | Enter the hours of Sick Pool time taken here rounded to quarter of hours (.25). | |
| Subtract Other Paid Time Off (K) | Enter the hours of other paid time off taken here rounded to quarter of hours (.25). You need to enter a code in Step 23 to account for this time. | |
| Subtract Leave Without Pay (L) | Enter the hours of leave without pay taken here rounded to quarter of hours (.25). | |
| Code (See Below) | Refer to the chart in Step 56 to determine what code to use to account for other paid time off entered in Step 21. | |
| Time to be Accounted For (M) | This displays the amount of time that still needs to be accounted for in Steps 15 through 22. If each day displays a '-', then there is no additional time to account for and you can proceed to Step 52. | |
| Total Actual Hours Worked this Period | Total number of hours worked during this Entry Period. | |
| Total Normal Expect Hours Worked this Period | The total number of hours you expect to work during the payperiod is automatically calculated. | |
| Total Actual Over (Under) Expected this Period | This is the total number of hours that need to be accounted for in Steps 15 through 22 throughout the entire Entry Period. | |
| Total Overtime at Straight Time this Period | Total number of hours of overtime worked at straight time over the entire Entry Period. | |
| Total Comp Time Earned at Straight Time this Period | Total number of comp time hours earned at straight time over the entire Entry Period. | |
| Total Comp Time Earned at Premium Time this Period | Total number of comp time hours earned at premium time over the entire Entry Period. | |
| Total Comp Time Taken this Period | Total number of comp time hours taken at straight time over the entire Entry Period. | |
| Total Earned Time Taken this Period | Total number of earned time hours taken over the entire Entry Period. | |
| Total Sick Pool Time Taken this Period | Total number of Sick Pool hours taken over the entire Entry Period. | |
| Total Other Paid Time Off this Period | Total number of other paid time off hours taken over the entire Entry Period. | |
| Total Leave Without Pay this Period | Total number of leave without pay hours taken over the entire Entry Period. | |
| Comp Time at Straight Time per column (F) | Displays the total number of comp time hours earned subject to straight time. | |
| Comp Time at Premium Time Hours x 1 1/2 per column (G) | Displays the total number of comp time hours earned subject to premium time. | |
| Total Comp Time Hours Earned | Displays the total number of comp time hours earned. | |
| Comp Time Taken per column (H) | Displays the total number of comp time hours taken. | |
| Comp Time Balance Forward from Last Report | Comp time balance forward from last entry period or from 'Comp Time' field on Standard Information Sheet if this is the Entry Period 1. | |
| Comp Time Ending Balance to Next Report | Total Comp Time available. Carried over to the next entry period. | |
| Earned Time Balance Forward from Last Report | Earned time balance forward from last entry period or from 'Earned Time' field on Standard Information Sheet if this is the Entry Period 1. | |
| Accrual Rate | Accrual rate used for current entry period displayed. If blank, then enter the accrual rate in the first (or second, if necessary) accrual rate field on the Normal Work Hours sheet. | |
| Total Earned Time Hours Earned | Automatically calculated based on the difference between the total normal expected hours in Step 26 and the total leave without pay hours in Step 35 multipled by the accrual rate in Step 46. | |
| Earned Time Taken, per column (I) | Total earned time hours taken as per Step 32. | |
| Minimum Usage & Other Adjustments | Allows for adjustments to balances for situations such as: earned time conversion to sick pool, leave without pay, use of sick pool beyond the first 15 days. | |
| Earned Time Ending Balance To The Next Report | Total Earned Time available. Carried over to the next entry period. | |
| Sick Pool Balance Forward From Last Report | Sick Pool balance forward from last entry period or from 'Sick Pool' field on Standard Information Sheet if this is the Entry Period 1. | |
| Sick Pool Taken, per column (J) | Total sick pool hours taken as per Step 33. | |
| Sick Pool Conversion, Minimum Usage & Other Adjustments | Allows for adjustments to balances for employees not required to participate in the earned time program. These employees will insert accrued time (.0577 x Total Expected Hours Worked) per pay period (see #26). Allows also for adjustments to balances for the purpose of sick pool conversion. | |
| Sick Pool Ending Balance To The Next Report | Total Sick Pool available. Carried over to the next entry period. | |
| Employee signature | The employee that filled out the form must sign here after it has been printed. | |
| Date | The date when the employee signed this form. | |
| Supervisor signature | The employee's supervisor must sign here (after it has been printed) if the supervisor agrees with the all of the entries on the form. | |
| Date | The date when the employee's supervisor signed this form. | |
| Codes to Use | Chart of codes to be entered in Step 23 to explain Other Paid
Time Off in Step 21. Earn Codes to Use: 312 - Call-Back 313 - Call-Back (Holiday) 316 - Holiday (worked) 317 - Standby 318 - Standby (call in) No Data Entry Required: CD - Compassionate Donation CO - Curtailed Operations FM - Family Medical Leave HL - Holiday JD - Jury Duty M - Military Leave SPFL - Sick Pool Family Leave SPFLB - Sick Pool for Family - Bereavement/Funeral WC - Workers Comp. |
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| Date | Enter the date for the work day(s) (e.g., 07/10/00) |