How To Fill Out A Sick Leave, Sample

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How To Fill Out A Sick Leave, Sample
How To Fill Out A Sick Leave, Sample

Video: How To Fill Out A Sick Leave, Sample

Отличия серверных жестких дисков от десктопных
Video: How to write leave application for office//Sick leave application from work. 2023, January

Since July 22, 2011, a new procedure for filling out and issuing sick leaves has been in effect. The sick leave is filled out by the attending physician and the employer of the sick person. The new form of the certificate of incapacity for work introduced this year is characterized by the most encrypted form and the presence of a large amount of information that allows the identification of the insurance company and the insured person.

How to fill out a sick leave, sample
How to fill out a sick leave, sample

It is necessary

  • - sick leave;
  • - pen with black paste.


Step 1

If you are an employer, you will have to meet often with filling out sick leaves. Under the new rules for the design of sick leaves, fill them in block letters in black ink or using printing devices. Place your entries in the specially designated cells, starting with the first of them. Make sure that all records do not go beyond the boundaries of the cells. If the text does not fit, just stop recording.

Step 2

In the column "place of work - name of the organization" indicate the abbreviated or full name of the organization, put a tick in the columns "main place of work" or "part-time", write the number of the policyholder assigned by the body of the Social Insurance Fund. (column "registration number"), put the 5-digit subordination code in the appropriate column.

Step 3

If you have an individual tax number for a disabled person, indicate it on your sick leave. Do not fill in this field during pregnancy or childbirth. Indicate the number of the insurance certificate of the Pension Fund in the "SNILS" column, and in the "Accrual conditions" column, enter one or more codes.

Step 4

So, 43 code is put if the insured has the right to benefits as a person exposed to radiation; 44 - if the employee works in the Far North or in conditions equivalent to it, and started working in this area before 2007. 45 - in case of disability, 46 - in the presence of an employment contract for up to 6 months, 47 - if the loss of ability to work occurred within 30 days after dismissal. 48 - in case of violation of the regime for a good reason, 49 - if the incapacity for work lasts 4 months in a row (issued for employees with disabilities). 50 - if the incapacity for work exceeds 5 months a year (for disabled people). 51 applies to the insured person working part-time.

Step 5

In addition, in the sick leave in the columns of the same name, indicate the date of entry to work, length of service, non-insurance periods (military service), average daily earnings, the amount of benefits, the total amount to be paid (the “total accrued” column).

Step 6

Certify the sick leave with the signature of the head and the chief accountant. When putting a stamp on a sick leave, pay attention to the fact that the stamp does not cover the information.

If you are a self-employed person, please sign both boxes.

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