PRIVATE AND CONFIDENTIAL
Absence Monitoring
To be completed by employee when absent through sickness or injury for seven calendar day or less. Name
Job title
Establishment
Establishment number
ConocoPhillips
692306
The dates shown below should be the actual dates of sickness or injury and where applicable should include non working days (e.g. Saturday and Sunday) as well as days you normally should have worked. I hereby certify that by reason of personal illness or injury I was incapacitated.