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# OFFICE OF THE CLERK## U.S. HOUSE OF REPRESENTATIVES# PERSONAL LEAVE RECORD## 1978TRIPLETT, BillName of EmployeeAddressAddressPhone NumberPosition TitiaPosition Number Level StepDATE OF APPOINTMENT7-17-77PRIOR FEDERAL SERVICEYears MonthsANNUAL LEAVE CATEGORY1.  02.  53.  0BALANCE BROUGHT FORVARD FROM PRECEDING YEARAnnual Leave 5Sick Leava 5| 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  | 25  | 26  | 27  | 28  | 29  | 30  | 31  | ACCRUED THIS MONTH          | AVAILABLE THIS MONTH | USED THIS MONTH | BALANCE AT CLOSE OF MONTH | EMPLOYEE INITIALS       || ----- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --------------------------- | -------------------- | --------------- | ------------------------- | ----------------------- || Jan.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     | Annual Leave / Sick Leave / | Annual Leave         | Sick Leave      | Annual Leave Sick Leave   | Annual Leave Sick Leave || Гев.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     | //                          |                      |                 | 7 7                       |                         || Mar.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     | //                          |                      |                 | 8 8                       |                         || Apr.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     | //                          |                      |                 | 9 9                       |                         || May   |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     | //                          |                      |                 | 10 10                     |                         || June  |     |     |     |     |     | X   | X   | X   |     | X   | X   | X   | X   |     |     |     |     |     |     |     |     |     |     |     |     |     | X   | X   | X   | X   |     | //                          |                      |                 | 11 11                     |                         || July  |     |     |     |     |     | X   | X   | X   |     | X   | X   | X   | X   |     |     |     |     |     |     |     |     |     |     |     |     |     | X   | X   | X   | X   |     | 8 12                        | 4                    | 8               | 0 12                      |                         || Aug.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     | //                          |                      |                 |                           |                         || Sept. |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |                             |                      |                 |                           |                         || Oct.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |                             |                      |                 |                           |                         || Nov.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |                             |                      |                 |                           |                         || Dec.  |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |     |                             |                      |                 |                           |                         |= 0.5 day annual leave= 1.0 day annual leave= 0.5 day sick leaveS or S = 1.0 day sick leave= 0.5 day administrative leaveA or A= 1.0 day administrative leaveU = 0.5 day unauthorized absencoU or U = 1.0 day unauthorized absence= 0.5 day leave without pay= 1.0 day leave without payCERTIFIED CORRECT:Employee's Signatura Date(If employee refuses to sign, state reason below.Approved:Chief's Signature DateClerk of the House DatoThis 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 INW 88326DocId:32244108 Page 3