[180-10070-10143.pdf — page 2]
# OFFICE OF THE CLERK# U.S. HOUSE OF REPRESENTATIVES# PERSONAL LEAVE RECORD# 1978RESNICK, GinaAddressAddressPhone NumberPosition TitlePosition NumberDate of Appointment: 6-13-77Annual Leave Category:1.01.52.0Prior Federal Service:Years ... Months ...Balance Brought Forward From Preceding Year:Annual Leave: 6Sick Leave: 3| Month | Step | Day of Month                                                                        | Available This Month | Accrued This Month | Used This Month | Balance at Close of Month | Employee Initials |            |              |            |     |     |     |     || ----- | ---- | ----------------------------------------------------------------------------------- | -------------------- | ------------------ | --------------- | ------------------------- | ----------------- | ---------- | ------------ | ---------- | --- | --- | --- | --- ||       |      | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 | Annual Leave         | Sick Leave         | Annual Leave    | Sick Leave                | Annual Leave      | Sick Leave | Annual Leave | Sick Leave |     |     |     |     || Jan.  |      | S S S                                                                               |                      |                    | 7               | 1                         |                   |            | 4            |            | 3   | 7   | 1   |     || Feb.  |      | S                                                                                   |                      |                    | 8               | 1                         |                   |            | 2            |            | 1   | 7   | 1   |     || Mar.  |      | XXX                                                                                 |                      |                    | 9               | 1                         |                   |            | 3            |            | 3   | 8   | 2   |     || Apr.  |      | XXX                                                                                 |                      |                    | 7               | 1                         |                   |            | 4            |            | 5   | 6   | 3   |     || May   |      | XXXXX                                                                               |                      |                    | 3               | 1                         |                   |            | 5            |            | 3   | 2   | 4   |     || June  |      | XXX                                                                                 |                      |                    |                 |                           |                   |            | 3            |            | 3   | 0   | 5   |     || July  |      |                                                                                     |                      |                    |                 |                           |                   |            |              |            |     |     |     |     || Aug.  |      |                                                                                     |                      |                    |                 |                           |                   |            |              |            |     |     |     |     || Sept. |      |                                                                                     |                      |                    |                 |                           |                   |            |              |            |     |     |     |     || Oct.  |      |                                                                                     |                      |                    |                 |                           |                   |            |              |            |     |     |     |     || Nov.  |      |                                                                                     |                      |                    |                 |                           |                   |            |              |            |     |     |     |     || Dec.  |      |                                                                                     |                      |                    |                 |                           |                   |            |              |            |     |     |     |     |[Figure: A table with leave accrual and usage data for each month.]☑ = 0.5 day annual leave☐ = 1.0 day annual leave☑ or S = 0.5 day sick leave☐ or S = 1.0 day sick leave☑ or A = 0.5 day administrative leave☐ or A = 1.0 day administrative leave☑ or U = 0.5 day unauthorized absence☐ or U = 1.0 day unauthorized absence☑ = 0.5 day leave without pay☐ = 1.0 day leave without payCERTIFIED CORRECT:Employee's Signature(If employee refuses to sign, state reason below)DateApproved:Chief's SignatureDateClerk of the HouseDateThis 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