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# OFFICE OF THE CLERK# U.S. HOUSE OF REPRESENTATIVES# PERSONAL LEAVE RECORD# 1978ISRAEL, SonnyName of EmployeeAddressAddressPhone NumberDATE OF APPOINTMENT6-27-77ANNUAL LEAVECATEGORY1.  0PRIOR FEDERAL SERVICE1.  5Position TulaPosition NumberLevelStepYearsMonths2.  0|                  |     |     |     |     |     |     |     |                        |                          |                     |                               |              | Employee Initials                                || ---------------- | --- | --- | --- | --- | --- | --- | --- | ---------------------- | ------------------------ | ------------------- | ----------------------------- | ------------ | ------------------------------------------------ ||                  |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || **DAY OF MONTH** |     |     |     |     |     |     |     |                        |                          |                     |                               |              | **DAL ANCC BROUGHT FORWARD FROM PROCLDING YEAR** || **Month**        | 1   | 2   | 3   | 4   | 5   | 6   | 7   | 8                      | 9                        | 10                  | 11                            | 12           |                                                  ||                  | 13  | 14  | 15  | 16  | 17  | 18  | 19  | 20                     | 21                       | 22                  | 23                            | 24           | Annual Leave / Sick Leave                        ||                  | 25  | 26  | 27  | 28  | 29  | 30  | 31  | **ACCRUED THIS MONTH** | **AVAILABLE THIS MONTH** | **USFD THIS MONTH** | **BALANCE AT CLOSE OF MONTH** |              |                                                  ||                  |     |     |     |     |     |     |     | Annual Leave           | Sick Leave               | Annual Leave        | Sick Leave                    | Annual Leave | Sick Leave                                       || Jan.             | S   |     |     |     |     |     |     |                        |                          | 2                   | 7                             | 2            | 6                                                || Feb.             |     | S   |     |     |     | XXX |     |                        |                          | 3                   | 7                             | 1            | 6                                                || Mar.             |     |     | XXX |     |     |     |     |                        |                          |                     |                               |              |                                                  || Apr.             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || May              |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || June             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || July             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || Aug.             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || Sept.            |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || Oct.             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || Nov.             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  || Dec.             |     |     |     |     |     |     |     |                        |                          |                     |                               |              |                                                  |Terminated 3/8/78☑ = 0.5 day annual leave☐ = 1.0 day annual leave☑ = 0.5 day sick leaveS or ☐ = 1.0 day sick leave☐ = 0.5 day administrative leaveA or ☐ = 1.0 day administrative leave☐ = 0.5 day unauthorized absenceU or ☐ = 1.0 day unauthorized absence☐ = 0.5 day leave without pay☐ = 1.0 day leave without payEmployee's Signature(If employee refuses to sign, state reason below.CERTIFIED CORRECT:DateApproved:Chief's SignatureClerk of the HouseDateDateThis record will be forwarded to the Clerk of the House at the end of each calendar year, or in case of termination, along with the request for termination. Upon approval, the record will be filed in the employee's official personnel folder.EXHIBIT I