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{"sheet":"Benefits Usage","index":0,"n_rows":49,"n_cols":47,"rows_kept":49,"cut":false,"hidden":false,"merged":[[31,1,35,56],[25,46,25,56],[24,46,24,56],[26,46,26,56],[27,46,27,56],[28,1,29,45],[30,1,30,56],[28,46,29,56],[25,1,25,45],[24,1,24,45],[46,1,46,56],[38,28,43,53],[36,1,36,56],[38,3,40,23],[41,3,43,23],[0,26,2,56],[3,1,3,56],[23,1,23,56],[26,1,26,45],[27,1,27,45],[8,1,8,32],[4,1,5,10],[7,1,7,32],[7,33,7,45],[7,46,7,56],[6,1,6,56],[8,46,8,56],[8,33,8,45],[15,1,16,45],[17,1,18,45],[9,1,9,56],[15,46,16,56],[17,46,18,56],[19,1,20,45],[19,46,20,56],[21,1,22,45],[21,46,22,56],[12,1,12,54],[10,1,10,56],[11,1,11,56],[13,46,14,56],[13,1,14,45]]}
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Salaried Employee Benefits            Usage Form"]
[]
[]
[]
[null,"Reporting Period:"]
[]
[null,"General Information"]
[null,"Employee Name:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Employee ID:",null,null,null,null,null,null,null,null,null,null,null,null,"Date:"]
[]
[null,"Department:"]
[null,"  "]
[]
[null,"Benefit Usage  (If benefits were not used, enter a zero.)"]
[null,"Total of Vacation Leave Days Used:"]
[]
[null,"Total of Personal Sick Leave Days Used:"]
[]
[null,"Total of Family Sick Leave Days Used:"]
[]
[null,"Total of State of Illinois Paid Leave Days Used:"]
[]
[null,"Total of Huskies Give Back Days Used:"]
[]
[null,"In accordance with state law and university policy, I certify that the benefit usage reflected above are true and accurate based on hours worked this month."]
[null,"Employee Signature:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Date:"]
[]
[null,"Supervisor Signature:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Date:"]
[]
[null,"How many of the above leave days (vacation, personal sick and/or family sick) were used for an approved leave under the Family and Medical Leave Act?"]
[]
[null,"Comments:  (Include date(s) and amount of leave documented above)"]
[]
[]
[]
[]
[]
[null,"Conversion Information"]
[]
[null,null,"\n","          \nConversion from Hours to  Days\nFORMULA:    Hours Used /  7.5  = Days\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Hours to Days Calculator"]
[]
[]
[null,null,null,"2 hours used /  7.5 =  .27 days\n4 hours used /  7.5 =  .53 days\n6 hours used /  7.5 =  .80 days"]
[]
[]
[]
[]
[null,"FOR COPY/TRANSFER USE ONLY  (NOTE:  WHEN PASTING THIS INTO THE SUMMARY SHEET, USE \"PASTE SPECIAL\" AND SELECT VALUES.)"]
[null,"VAC","SL-P","SL-F","IPL","HGB"]
[null,{"$f":"SUM(AU14)","v":0},{"$f":"SUM(AU16)","v":0},{"$f":"SUM(AU18)","v":0},{"$f":"SUM(AU20)","v":0},{"$f":"SUM(AU22)","v":0}]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Instructions and Guidelines for the Salaried Employee Benefits Usage Statement"]
["Benefits Usage Guidelines"]
[null,null,null,null,null,"All salaried employees, enrolled in a leave plan, are required to submit an Employee Benefits Usage Statement each and every month. Statements are to be submitted to the supervisor or other designated department coordinator on the 1st of each month. The only exception to this is for employees that are eligible for State of Illinois Paid Leave benefits and/or Huskies Give Back only.  These employes are only required to submit an Employee Benefit Usage Statement when they have usage.\n\n\n"]
[null,null,null,null,null,"Specific eligibility criteria and provisions for benefit leaves, for civil service employees, Faculty/SPS, FMLA guidelines and Sick Leave banks, can be found in the NIU Board of Trustees Regulations or at the https://www.niu.edu/board/regs/ web address, or the HR website:  https://www.hr.niu.edu/hrs/current-employees/benefits/leaves/index.shtml"]
[null,null,null,null,null,"Board of Trustee Regulations and the State Officials and Employees Ethics Act (SOEEA) require that all leave time taken (vacation, sick leave, FMLA, or any other leave authorized pursuant to Board of Trustees Regulations and university policies) be recorded to the nearest quarter hour (see example and formula below). Each leave type on the Benefit Usage Form, needs to be broken down by individual leave type and reported in total DAYS.  In addition, time taken \"for any political candidate or partisan purpose other than educational\" must be documented as either vacation, state of Illinois paid leave, or unpaid leave time.  The date(s) and total amount of time taken for all leave time documented during the reporting period must be recorded in the \"Comments\" section of the Benefits Usage Form. Personal sick is to be reported for the employee, family sick is to be reported when caring for an employee’s family member or member of their immediate household.\n "]
[null,null,null,null,null,"As part of the required institutional compliance with the State Finance Act and the State Officials and Employees Act, a number of important responsibilities are delegated to supervisors, departments and colleges throughout the university.  These responsibilities include verification and authorization of the time worked records that are incorporated into the Hourly Time Sheet and Salaried Employee Benefits Usage Form.  When a department authorizes a time sheet or benefit usage form, that department is attesting to the accuracy of the information contained therein.  Accordingly, supervisors are directly responsible for monitoring the hours of work and other provisions recorded in these documentation formats."]
[null,null,null,null,null,"Please be reminded that most leave accruals are based and prorated on the appointment percentage or FTE value.\nThe balances of your leave accruals will appear on your pay check or payment advice.  Remember though that the balances of your leave accruals are only reconciled on a monthly basis and the delay in reporting actual monthly usage may cause some discrepancies in your pay check/advice amounts.  Contact HRS if there are any questions.\n"]
[" ",null,null,null,null,null,null,null,"Note :",null,null,null,"Use of all leaves shall be arranged with due regard for the operational needs of the university and shall require supervisory approval.  The use and reporting of all leave time benefits shall be in strict compliance with departmental and University policies.  "]
[]
["General Information"]
[null,null,null,null,null,"Reporting Period"]
[null,null,null,null,null,null,null,null,null,null,"Complete the reporting period indicating the month and year."]
[null,null,null,null,null,"Employee Name"]
[null,null,null,null,null,null,null,null,null,null,"Fill in your name. If using a printed form, please print your name."]
[null,null,null,null,null,"Employee ID"]
[null,null,null,null,null,null,null,null,null,null,"Enter the Employee ID assigned by the HRS PeopleSoft system.  This is an eight (8) digit number.  (Do not confuse this with SSN)."]
[null,null,null,null,null,"Date"]
[null,null,null,null,null,null,null,null,null,null,"Fill in with the current date."]
[null,null,null,null,null,"Department"]
[null,null,null,null,null,null,null,null,null,null,"Enter the Department ID.  This as a 7 character code, two characters followed by 5 zeros.  (Only one department per form)"]
["Benefit Usage"]
[null,null,null,null,null,"Total Vacation Days Used"]
[null,null,null,null,null,null,null,null,null,null,"Enter the total number of approved vacation DAYS used during the period specified in the Reporting Period field."]
[null,null,null,null,null,"Total of Personal Sick Leave Days Used"]
[null,null,null,null,null,null,null,null,null,null,"Enter the total number of personal sick DAYS used during the period specified in the Reporting Period field."]
[null,null,null,null,null,"Total of Family Sick Leave Days Used"]
[null,null,null,null,null,null,null,null,null,null,"Enter the total number of family sick DAYS used during the period specified in the Reporting Period field."]
[null,null,null,null,null,"Total of State of Illinois Paid Leave Days Used"]
[null,null,null,null,null,null,null,null,null,null,"Enter the total number of approved state of Illinois paid leave DAYS used during the period specified in the Reporting Period field."]
[null,null,null,null,null,"Total of Huskies Give Back Days Used"]
[null,null,null,null,null,null,null,null,null,null,"Enter the total number of approved huskies give back DAYS used during the period specified in the Reporting Period field."]
[null,null,null,null,null,null,null,null,null,null,null,null,"All leaves may be recorded in whole days or fractions of days. Fractions of days may be recorded by dividing the number of hours used by 7.5.  Note that \"days\" are based on the standard 7.5 hour work day.  Note:  In those instances where a contract specifies a standard 8 hour work day use (Hours Used / 8.0) to calculate days used."]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"For Example:",null,null,null,null,null,null,null,"FORMULA: Hours Used /  7.5 = Days"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2 hours taken /  7.5 =  .27 days\n4 hours taken /  7.5 =  .53 days\n6 hours taken /  7.5 =  .80 days"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Note :",null,null,"Benefit usage and leave time reported in accordance with the SOEEA compliance program must be reported to the nearest quarter hour (see example and formula above.)  SOEEA reporting does not replace Benefit Usage reporting.  \n\nEmployees should contact their supervisors for the appropriate and customary precision by which benefit usage should be reported.  "]
[null,null,null,null,null,"FMLA"]
[null,null,null,null,null,null,null,null,null,null,"Enter the number of above listed vacation, personal sick, family sick, and state of Illinois paid leave days to be applied to an APPROVED Family and Medical Leave Act (FMLA) program."]
[null,null,null,null,null,"Comments"]
[null,null,null,null,null,null,null,null,null,null,"In the Comments section, note date(s) and amount of all leave including vacation, sick leave, state of Illinois paid leave, approved Huskies give back, jury duty, bereavement, funeral leave, military leave or any unpaid leave time declared."]
[null,null,null,null,null,"Employee's Signature"]
[null,null,null,null,null,null,null,null,null,null,"The employee’s signature certifies that the days listed above are a true and accurate representation of the benefits utilized in the pay period."]
[]
[null,null,null,null,null,"Supervisor's Signature"]
[null,null,null,null,null,null,null,null,null,null,"The supervisor’s signature certifies that the days listed above are a true and accurate representation of the benefit time that was approved and utilized by the employee.  A supervisor’s signature is required for a benefit usage form to be processed and the employee to be paid."]

{"sheet":"Date","index":2,"n_rows":15,"n_cols":2,"rows_kept":15,"cut":false,"hidden":true,"merged":[]}
["January",2023]
["February",2024]
["March",2025]
["April",2026]
["May",2027]
["June",2028]
["July",2029]
["August",2030]
["September",2031]
["October",2032]
["November"]
["December"]
[]
[]
[1,1]