Record of Absence - Self-Certification Form

State:
Multi-State
Control #:
US-457EM
Format:
Word; 
Rich Text
Instant download

Understanding this form

The Record of Absence - Self-Certification Form is a crucial document for employees and employers to record periods of sickness absence. This form is used to ensure that absences are documented accurately, allowing the employer to monitor overall sickness trends while maintaining confidentiality. It simplifies the process of self-reporting absence and is essential for formalizing communication regarding time off work due to illness, differing from forms used for other leave categories like vacation or personal days.

Form components explained

  • Employee details: Personal information of the employee submitting the form.
  • Dates of absence: Specify the start and end dates of the sickness absence.
  • Reason for absence: Include the specific illness or condition causing the absence.
  • Manager's confirmation: Section for the line manager to confirm the employee's absence.
  • Medical certificate requirement: Guidance on obtaining a medical certificate for absences longer than seven days.
  • Declaration of accuracy: Employee's acknowledgment declaring that the provided information is correct.
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When to use this form

This form should be used whenever an employee is absent from work due to illness. If the absence lasts less than seven days, the form can be completed upon returning to work. If the absence extends beyond seven days, the employee or their manager should fill out the form promptly to document the early period of absence and ensure compliance with company policies.

Who should use this form

  • Employees who are absent from work due to illness.
  • Employers or HR personnel managing employee sickness records.
  • Line managers overseeing employees on sick leave.

Completing this form step by step

  • Fill out your personal details in the designated sections.
  • Enter the dates for your period of absence due to illness.
  • Select the reason for your absence from the given options.
  • If applicable, ensure your line manager confirms your absence on the form.
  • Remember to secure a medical certificate if your absence exceeds seven days.
  • Sign the declaration to confirm that all information is accurate.

Notarization requirements for this form

This form does not typically require notarization to be legally valid. However, some jurisdictions or document types may still require it. US Legal Forms provides secure online notarization powered by Notarize, available 24/7 for added convenience.

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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

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We protect your documents and personal data by following strict security and privacy standards.

Common mistakes

  • Failing to specify the correct dates of absence.
  • Not providing a valid reason for the absence.
  • Neglecting to obtain a medical certificate for extended absences.
  • Missing the required signature or declaration section.

Why use this form online

  • Convenient access to the form from any device at any time.
  • Editability allows you to fill in and save the form for later completion.
  • Reliability in maintaining records securely and confidentially.
  • Immediate download and easy submission to your employer.

Main things to remember

  • The Record of Absence - Self-Certification Form is essential for documenting employee sickness absence.
  • Use this form for absences under seven days without a medical certificate.
  • Timely completion and submission are critical to ensure compliance with workplace policies.

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FAQ

Many employers have their own self-certification forms. If your employer doesn't have its own form you can download this Self Certification Form (PDF). Please print it, fill it in and hand it in to your employer. You do not need to see a Doctor.

If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. Instead they can ask you to confirm that you've been ill. You can do this by filling in a form yourself when you return to work. This is called self-certification.

Many employers have their own self-certification forms. If your employer doesn't have its own form you can download this Self Certification Form (PDF). Please print it, fill it in and hand it in to your employer. You do not need to see a Doctor.

Sickness Certificates Your employer may require you to complete a self-certification form called an SC2 which is available from the HMRC website or you can click on the link below to download a form.

If you can't get form SSP1 or a written statement from your employer, contact HMRC's employees' enquiry line on 0300 200 3500. They'll ask your employer why they think you're not entitled to SSP.

If you are off work for less than seven days, you are responsible for your own self-certification on form SC1 (available from reception or any post office).

Sickness Certificates Your employer may require you to complete a self-certification form called an SC2 which is available from the HMRC website or you can click on the link below to download a form.

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Record of Absence - Self-Certification Form