GSA Form 873 2018 Annual Attendance Record

GSA form 873 or the "Annual Attendance Record" is a form issued by the U.S. General Services Administration.

Download a fillable PDF version of the GSA Form 873 down below or find it on the U.S. General Services Administration Forms website.

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TOUR OF DUTY
LEGEND:
SUGGESTED CODES:
= Last day of Month
A = Annual Leave
S = Sick Leave
E = Excused
W = Absent Without Leave
CE = Compensation Time Earned
OT = Overtime
H
= Holiday
M = Military Leave
R = Restored Leave
D = Award Leave
L = Leave Without Pay
CU = Compensation Time Used
C = Continuation of Pay for Traumatic
PER PAY PERIOD
PER LEAVE YEAR
ANNUAL LEAVE
SICK LEAVE
LEAVE CATEGORY
ANNUAL
SICK
ANNUAL
SICK
*10 hours pay period ending 12/22.
4
4
4
104
104
CARRY-OVER
CARRY-OVER
6
6*
4
160
104
OPENING BALANCE
OPENING BALANCE
8
8
4
208
104
PAY PERIOD
USED
USED
THIS PAY PERIOD
THIS PAY PERIOD
TO
BALANCE
TO
BALANCE
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
DATES
CODE
DATE
DATE
EARNED
USED
EARNED
USED
H
2
1/7 - 1/20
3
1/21 - 2/3
4
2/4 - 2/17
H
5
2/18 - 3/3
6
3/4 - 3/17
7
3/18 - 3/31
8
4/1 - 4/14
9
4/15 - 4/28
10
4/29 - 5/12
11
5/13 - 5/26
H
12
5/27 - 6/9
13
6/10 - 6/23
H
14
6/24 - 7/7
15
7/8 - 7/21
16
7/22 - 8/4
17
8/5 - 8/18
18
8/19 - 9/1
H
19
9/2 - 9/15
20
9/16 - 9/29
H
21
9/30 - 10/13
22
10/14 - 10/27
23
10/28 - 11/10
H
H
24
11/11 - 11/24
25
11/25 - 12/8
26
12/9 - 12/22
H
H
1
12/23 - 1/5
ADDRESS (Street, City, State, and ZIP Code)
LEAVE CATEGORY CODE
BLOCK NUMBER
SERVICE COMPUTATION DATE
The untitled columns above
and on the back provide
space to record other leave
LAST NAME, FIRST NAME, MIDDLE INITIAL
TELEPHONE NUMBER
ENTERED ON OR TRANSMITTAL DATE
or premium pay categories
that may apply.
ANNUAL ATTENDANCE RECORD - 2018
GSA 873 (REV. 12/2017)
GENERAL SERVICES ADMINISTRATION
(Also known as OF 873)
PREVIOUS EDITION IS NOT USABLE
Sensitive, but Unclassified
TOUR OF DUTY
LEGEND:
SUGGESTED CODES:
= Last day of Month
A = Annual Leave
S = Sick Leave
E = Excused
W = Absent Without Leave
CE = Compensation Time Earned
OT = Overtime
H
= Holiday
M = Military Leave
R = Restored Leave
D = Award Leave
L = Leave Without Pay
CU = Compensation Time Used
C = Continuation of Pay for Traumatic
PER PAY PERIOD
PER LEAVE YEAR
ANNUAL LEAVE
SICK LEAVE
LEAVE CATEGORY
ANNUAL
SICK
ANNUAL
SICK
*10 hours pay period ending 12/22.
4
4
4
104
104
CARRY-OVER
CARRY-OVER
6
6*
4
160
104
OPENING BALANCE
OPENING BALANCE
8
8
4
208
104
PAY PERIOD
USED
USED
THIS PAY PERIOD
THIS PAY PERIOD
TO
BALANCE
TO
BALANCE
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
DATES
CODE
DATE
DATE
EARNED
USED
EARNED
USED
H
2
1/7 - 1/20
3
1/21 - 2/3
4
2/4 - 2/17
H
5
2/18 - 3/3
6
3/4 - 3/17
7
3/18 - 3/31
8
4/1 - 4/14
9
4/15 - 4/28
10
4/29 - 5/12
11
5/13 - 5/26
H
12
5/27 - 6/9
13
6/10 - 6/23
H
14
6/24 - 7/7
15
7/8 - 7/21
16
7/22 - 8/4
17
8/5 - 8/18
18
8/19 - 9/1
H
19
9/2 - 9/15
20
9/16 - 9/29
H
21
9/30 - 10/13
22
10/14 - 10/27
23
10/28 - 11/10
H
H
24
11/11 - 11/24
25
11/25 - 12/8
26
12/9 - 12/22
H
H
1
12/23 - 1/5
ADDRESS (Street, City, State, and ZIP Code)
LEAVE CATEGORY CODE
BLOCK NUMBER
SERVICE COMPUTATION DATE
The untitled columns above
and on the back provide
space to record other leave
LAST NAME, FIRST NAME, MIDDLE INITIAL
TELEPHONE NUMBER
ENTERED ON OR TRANSMITTAL DATE
or premium pay categories
that may apply.
ANNUAL ATTENDANCE RECORD - 2018
GSA 873 (REV. 12/2017)
GENERAL SERVICES ADMINISTRATION
(Also known as OF 873)
PREVIOUS EDITION IS NOT USABLE
Sensitive, but Unclassified
This optional form is for timekeepers to use in recording daily and bi-weekly pay and leave activity. The form is a record of what SHOULD BE recorded into the official payroll system.
The bi-weekly Earnings and Leave Statement, the Supervisor's Time and Attendance Report, and the Premium Pay Report as well as other management reports reflect what IS in the
official payroll system. Those reports should agree with the data on this form. The untitled columns on this form may be used to maintain usage and balances for any leave and
premium pay categories that may apply for an individual employee. Examples: Leave categories - Shared (Donated), Restored, Award, Family Friendly (Sick or Medical), Military,
Compensatory Leave, and Credit Hours. Premium Pay hours include Environmental Differential Pay, Sunday Premium, Night Differential, as well as Overtime, and can be included.
OTHER TYPES OF LEAVE CATEGORIES
PAY PERIOD
CODE
DATES
2
1/7 - 1/20
3
1/21 - 2/3
4
2/4 - 2/17
5
2/18 - 3/3
6
3/4 - 3/17
7
3/18 - 3/31
8
4/1 - 4/14
9
4/15 - 4/28
10
4/29 - 5/12
11
5/13 - 5/26
12
5/27 - 6/9
13
6/10 - 6/23
14
6/24 - 7/7
15
7/8 - 7/21
16
7/22 - 8/4
17
8/5 - 8/18
18
8/19 - 9/1
19
9/2 - 9/15
20
9/16 - 9/29
21
9/30 - 10/13
22
10/14 - 10/27
23
10/28 - 11/10
24
11/11 - 11/24
25
11/25 - 12/8
26
12/9 - 12/22
1
12/23 - 1/5
GSA 873 (REV. 12/2017) BACK
(Also known as OF 873)

Download GSA Form 873 2018 Annual Attendance Record

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