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Employee Name:FMLA Entitlement Hours:Banner ID:FMLA Hours Previously Used in Past 12 months:FMLA Start Date:Balance Available for this FMLA:FMLA End Date:FMLA Event: FMLA TypeFrequency per CertificationSection A. 2014 FMLA UsageMonth12345678910111213Jan24Feb2Mar4Apr4May4JunJulAugSepOctNovDecTotal: Section B. 2013 FMLA Rolling Calendar Recovery of Time Used Month12345678910111213Jan4Feb4Mar4AprMayJunJulAugSepOctNovDecTotal: ................
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