FMLA ABSENCE TRACKING CALENDAR FML Hours Avail. 480.

0
Post eligibility and FML request info in this cell
Employee Name: FML Hours Used 0.0

FMLA Start Date:

FML Save this document to your computer before completing it
Hours
FMLA Est. End Date: Avail.
480.0
Average hours scheduled per week prior to the start of FMLA 40.0

Instructions: Enter employee's name, leave start and end dates above. Also change the average hours above to what the employee is regularly scheduled to work on a weekly basis if not
40 hours per week. Below, indicate the year in which FMLA is used next to the month of first FML absence and enter hours of FML used under the appropriate day of the month. Continue
to complete the spreadsheet until the FML case is closed, the employee has used all of their available FML leave for the 12 month period, or the 12 month period has ended. The
formulas included will total FML time used and FML time available based upon the information you enter.

NOTE #1: You can HIDE rows for the months not needed by right clicking on the row number(s) to highlight the row(s) and select "hide", but DO NOT DELETE rows or columns. Deleting
cells may impact the imbedded formulas.

NOTE #2: For a rolling calendar year plans, any time missed that is more than one year old should be deleted from the spreadsheet to help determine appropriately if the employee has
any FML time available. For policies using a fixed 12 month period, create a new tab or spreadsheet for each 12 month period.

NOTE #3: See the SECOND tab for any FML requests to care for a Covered Service Member with a serious injury or illness (i.e. MILITARY CAREGIVER LEAVE)

Days of Month
Total FMLA hrs FMLA hrs
Month Year 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 Hrs/Mo. used available
January 0.00 0.00 480
February 0.00 0.00 480
March 0.00 0.00 480
April 0.00 0.00 480
May 0.00 0.00 480
June 0.00 0.00 480
July 0.00 0.00 480
August 0.00 0.00 480
September 0.00 0.00 480
October 0.00 0.00 480
November 0.00 0.00 480
December 0.00 0.00 480
January 0.00 0.00 480
February 0.00 0.00 480
March 0.00 0.00 480
April 0.00 0.00 480
May 0.00 0.00 480
June 0.00 0.00 480
July 0.00 0.00 480
August 0.00 0.00 480
September 0.00 0.00 480
October 0.00 0.00 480
November 0.00 0.00 480
December 0.00 0.00 480
 CAREGIVER FMLA ABSENCE TRACKING CALENDAR
Employee Name:

CAREGIVER FMLA Start Date:

CAREGIVER FMLA Est. End Date:

Average hours scheduled per week prior to the start of FMLA 40.0

Instructions: Enter employee's name, leave start and end dates above. Also change the average ho
hours per week. Below, indicate the year in which FMLA is used next to the month of first FMLA abs
complete the spreadsheet until the FMLA case is closed, the employee has used all of their available
included will total FMLA time used and FMLA time available based upon the information you enter.

NOTE #1: This Spreadsheet is set up ONLY for tracking FMLA time used to care for a covered serv
leave versus the 12 weeks of all other FMLA leave options. This 26 weeks is tracked separately fro

NOTE #2: You can HIDE rows for the months not needed by right clicking on the row number(s) to h
may impact the imbedded formulas.

NOTE #3: Caregiver leave uses the 12-month period measured formward from the date of an emplo
Caregiver tab or spreadsheet for each 12 month period.

NOTE #4 See the FIRST tab for an FMLA Calendar Tracking for all other types of FMLA leave.

Month Year 1 2 3 4 5 6 7 8 9 10
January
February
March
April
May
June
July
 August
September
October
November
December
January
February
March
April
May
June
July
August
September
October
November
December
KING CALENDAR Caregiver FMLA Hours Avail: 1040.0

Caregiver FMLA Hours Used : 0.0

Caregiver
FMLA
Hours
Avail:
1040.0

so change the average hours above to what the employee is regularly scheduled to work on a weekly basis if not 40
e month of first FMLA absence and enter hours of FMLA used under the appropriate day of the month. Continue to
s used all of their available FMLA leave for the 12 month period, or the 12 month period has ended. The formulas
he information you enter.

o care for a covered servicemember with a serious injury or illness. This FMLA allows for up to 26 weeks of FMLA
s is tracked separately from any other FMLA leave requests (even if they are in the same 12 month period).

on the row number(s) to highlight the row(s) and select "hide", but DO NOT DELETE rows or columns. Deleting cells

from the date of an employee's first FMLA leave to care for the covered servicemember begins. Create a new

ypes of FMLA leave.

Days of Month

11 12 13 14 15 16 17 18 19 20 21 22 23
 y basis if not 40
nth. Continue to
The formulas

weeks of FMLA
period).

ns. Deleting cells

eate a new

Caregiver Caregiver
Total FMLA hrs FMLA hrs
24 25 26 27 28 29 30 31 Hrs/Mo. used available
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040
0.00 0.00 1040