THE SCHOOL BOARD OF SARASOTA COUNTY, FLORIDA …

1 THE SCHOOL BOARD OF SARASOTA county , FLORIDA payroll services CERTIFICATE OF ABSENCE Instructions: Complete and sign form and give to your supervisor for approval. EMPLOYEE Employee Name (Print) This is to certify that it was (will be) necessary for me to be absent from my Cost Center on the following date(s). I have specified the number of hours I was (will be) absent for each date. Reason for absence (check one): Sick Leave (SK) Personal Leave Charged to Sick (PS) FMLA (Family Medical Leave Act) (FM) Union Duty (attach letter) (UD) Vacation Leave (VC) Non Duty Day with Pay (ND) Temporary Duty Elsewhere (TP) (reason below) (11-Month Instructional Only) Non Duty Day without Pay (NP)

2 Accrued Comp Leave (AC) (Calendar C-11 Month Administrators Only) Jury Duty (attach copy of notice) (JD) #A0 or XXX-XX- Cost Center Employee ID Number SSN Date Submitted Employee Signature ---------------------------------------- ---------------------------------------- ------------------------------------ SUPERVISOR Admin.

3 Comp. Time (attach approval) (CT) Line of Duty (Worker's Comp) (WC) Temporary Duty Elsewhere (TP) Suspended Without Pay (SW) Military Duty (attach copy of orders) (MD) Unauthorized Absence (UA) Supervisor Name (Print) Supervisor Signature Approval of Absence(s) Date Section (2) (b) FLORIDA Statutes, requires the employee claiming sick leave to file a written certificate setting forth when he/she was absent, that the absence was necessary, and that he/she is entitled to receive pay for such absence. This section of the law goes on to state "the district SCHOOL BOARD of any district may adopt rules under which the district SCHOOL superintendent may require a certificate of illness from a licensed physician or from the county health office.

4 RET: Master, 5FY, GS-1 SL 195 060-80-FIN Dupl., OSA Rev. 3-3-2017