GSA873A_23
Annual Attendance Record (Part-Time Employees) - 2023
GSA Form 873A, Annual Attendance Record (Part-Time Employees) - 2023, is a General Services Administration form, GSA 873A (REV. 12/2022). GSA hosts it in its forms library, and GSA's page lists its authority or regulation as ADM 5440.708.
The form says it is an optional form for timekeepers to use in recording daily and bi-weekly pay and leave activity, and that it is a record of what SHOULD BE recorded into the official payroll system. It says the bi-weekly Earnings and Leave Statement, the Supervisor's Time and Attendance Report and the Premium Pay Report reflect what IS in the official payroll system, and that those reports should agree with the data on this form.
The front holds one row for each 2023 pay period, from code 2 (1/1 - 1/14) to code 26 (12/3 - 12/16), then code 1 (12/17 - 12/30) and code 2 (12/31 - 1/13), with a box for each day, the leave earning rates for leave categories 4, 6 and 8, annual and sick leave columns and an Employee block. The back has untitled columns for other types of leave categories. The form is marked CUI When Filled In. You can fill it out free in your browser on this page and download the result without an account.
The legend lists A = Annual Leave, S = Sick Leave, E = Excused, W = Absent Without Leave, M = Military Leave, R = Restored Leave, D = Award Leave, L = Leave Without Pay, CE = Compensation Time Earned, CU = Compensation Time Used, OT = Overtime and C, printed as Continuation of Pay for Traumatic. H marks a holiday and a black square marks the last day of a month.
For leave categories 4, 6 and 8 the form prints annual leave earned per pay period of 1 hour per 20, 13 and 10 hours worked. For sick leave it says 1 hour is earned for each 20 worked, regardless of category.
One row per pay period, from code 2 (1/1 - 1/14) to code 26 (12/3 - 12/16), then code 1 (12/17 - 12/30) and code 2 (12/31 - 1/13). Each row has 14 day boxes, Sunday to Saturday twice, and holidays come printed as H.
Each section has a carryover box, leave hours and work hours, and per pay period columns for total hours worked, hours applied to leave earned, balance of hours worked, earned and used this pay period, used to date and balance.
Address, last name, first name and middle initial, leave category code, block number, telephone number, service computation date, and the entered on or transmittal date. A tour of duty box sits at the top right.
Untitled columns for each pay period. The form lists examples such as Shared (Donated), Restored, Award, Family Friendly (Sick or Medical), Military, Compensatory Leave and Credit Hours, plus premium pay such as Environmental Differential Pay, Sunday Premium, Night Differential and Overtime.
The front is one grid for the 2023 leave year. The back adds columns for other leave categories.
Enter the employee's name, address and telephone number, the leave category code, block number, service computation date and the entered on or transmittal date. The tour of duty box is at the top right.
Each of the annual leave and sick leave sections starts with a carryover box, plus leave hours and work hours boxes.
Use the suggested codes in the legend for the day boxes of each pay period. Holidays are already marked H on the 2023 grid.
Record total hours worked, hours applied to leave earned, balance of hours worked, leave earned and used this pay period, used to date and balance. For leave categories 4, 6 and 8 the form prints annual leave earned per pay period of 1 hour per 20, 13 and 10 hours worked. For sick leave it says 1 hour is earned for each 20 worked, regardless of category.
The form says the untitled columns may be used to maintain usage and balances for any leave and premium pay categories that may apply for an individual employee.
The form says the bi-weekly Earnings and Leave Statement, the Supervisor's Time and Attendance Report and the Premium Pay Report should agree with the data on this form.
The PDF has no line-by-line instructions. These steps follow the blocks it prints.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The PDF gives no filing address, recipient or signature line. It describes itself as an optional form for timekeepers and a record of what SHOULD BE recorded into the official payroll system.
This edition covers 2023: one row per pay period, from code 2 (1/1 - 1/14) to code 26 (12/3 - 12/16), then code 1 (12/17 - 12/30) and code 2 (12/31 - 1/13).
The footer reads GSA 873A (REV. 12/2022) and PREVIOUS EDITION IS NOT USABLE. Both pages are marked CUI When Filled In.
GSA's page for this form lists ADM 5440.708 as its authority or regulation and 12/2022 as the current revision date. The PDF itself prints no OMB number, Privacy Act statement or burden estimate.
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The form describes itself as a timekeeper's record. It prints no signature line, filing address or OMB number.
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The form prints GENERAL SERVICES ADMINISTRATION at the bottom left and the footer GSA 873A (REV. 12/2022). GSA hosts it in its forms library.
The form says it is an optional form for timekeepers to use in recording daily and bi-weekly pay and leave activity. Each copy records one part-time employee, named in the Employee block.
For leave categories 4, 6 and 8 the form prints annual leave earned per pay period of 1 hour per 20, 13 and 10 hours worked. For sick leave it says 1 hour is earned for each 20 worked, regardless of category.
The legend lists A = Annual Leave, S = Sick Leave, E = Excused, W = Absent Without Leave, M = Military Leave, R = Restored Leave, D = Award Leave, L = Leave Without Pay, CE = Compensation Time Earned, CU = Compensation Time Used, OT = Overtime and C, printed as Continuation of Pay for Traumatic. H marks a holiday and a black square marks the last day of a month.
No. The form says it is a record of what SHOULD BE recorded into the official payroll system, while the bi-weekly Earnings and Leave Statement, the Supervisor's Time and Attendance Report and the Premium Pay Report reflect what IS in it. Those reports should agree with the form.
From code 2 (1/1 - 1/14) to code 26 (12/3 - 12/16), then code 1 (12/17 - 12/30) and code 2 (12/31 - 1/13).
The front of the form says PREVIOUS EDITION IS NOT USABLE. This edition is Rev. 12/2022, printed in the footer as GSA 873A (REV. 12/2022).