Spreadsheet: 8ed26247-9b59-4e2c-90df-832e695f2a1b
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25
[NAME]
This form allows for 23 days.  If you require additional days, please attach an additional form.
DEPARTMENT NAME |  |  |  | Electrical and Computer Engineering |  |  |  |  |  |  |  |  |  |  |  |  | DEPT ID |  | 2005001
Person ID No.: |  |  |  |  |  | Surname: |  |  |  |  |  |  |  |  |  | First Name:
Employee Status: |  |  |  | Full Time |  | Part Time |  | Hours Worked Per Week |  |  |  |  |  |  |  |  | Fund Source: |  |  | Trust | Operating
Month
Date
OVERTIME |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Total
440 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
610 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
615 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
620 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
623 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
624 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
070 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
071 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
BANKED TIME
659 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
661 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
662 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
663 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
666 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
665 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
670 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
667 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
668 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
REGULAR SALARY (MONTHLY HOURLY EMPLOYEES)
002 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
SHIFT DIFFERENTIAL
625 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
630 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
640 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
RESPONSIBILITY PAY
685 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 | 0
LEAVE WITHOUT PAY
814 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
COMMENTS
SIGNATURES:
Date: |  |  |  |  | Printed Name: |  |  |  |  |  |  |  |  |  |  |  |  | Phone No.:
 |  |  |  |  | Authorization Signature:
If this is charged to a research project/trust account, I certify that all expenditures charged to my research project/trust account are for purposes for which the grant/donation was awarded. These expenditures comply with the sponsor spending/donor terms guidelines/restrictions and, (where applicable) the expenditures conform to the budget submitted to the sponsor.  These expenditures are in support of the research project/trust account named in the award/donation and there is supporting documentation to satisfy the relevance to research requirement.
The personal information on this form is collected for the purpose of managing personnel under Section 33c of the Freedom of Information and Protection of Privacy Act.  Certain personal information will be made available to federal and provincial departments and agencies under appropriate legislative authority.  For further information regarding the collection and use of the personal information, contact the Human Resource Services, 2-60 University Terrace, University of Alberta, 492-4555.
[NAME]: |  |  |  | Original:  Staff and Student Payments         Copy:  Department
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 2005-07-15 00:00:00