Grant County Absentee Form

Human Resources

Human Resources

Justin Saathoff, HR Coordinator

401 S. Adams Street

Fax: 765-668-4780

Phone: 765-651-2406

Email: jsaathoff@grantcounty.net

Employee Absentee Report

First and Last Name:

Department

ABSENT FROM WORK FROM:

ABSENT FROM WORK TO

Permission WITH PERMISSION WITHOUT PERMISSION

REASON FOR ABSENCE: ACCIDENT ILLNESS VACATION PERSONAL BUSINESS JURY DUTY OTHER

if reason is

EXPECTS TO RETURN TO WORK ON:

AT: (AM/PM)

Reported By:

Approved By:

Form Validation