This is a missing work form that students complete if they do not have the assignment ready to submit for that day. Instead, they will fill out the top part of the paper and turn it in in lieu of the assignment. This makes grading much easier when it is clear who did not turn it in, what got misplaced, vs. who was absent, etc.
When they turn in the missing work, I immediately find their form and circle how many days it was late and staple the paper to it. That way, I can still set it aside and grade it with everything else. The bottom portion gets returned with the student with their assignment, but the top portion is filed -- VERY useful for parent-teacher conferences!
This form is best printed on bright paper to keep it obvious what is the assignment and what is late.