EMPLOYEE NUMBER EMPLOYEE NUMBER
DAILY TIME RECORD DAILY TIME RECORD
NAME: NAME:
POSITION: POSITION:
FOR THE MONTH OF: FOR THE MONTH OF:
OFFICIAL HOURS: OFFICIAL HOURS:
PAY PERIOD: PAY PERIOD:
SERVICE: SERVICE:
D A.M. P.M. UNDERTIME OVERTIME D A.M. P.M. UNDERTIME OVERTIME
A A
DEPAR- DEPAR- MIN- MIN- DEPAR- DEPAR- MIN- MIN-
Y ARRIVAL
TURE
ARRIVAL
TURE
HOURS
UTES
HOURS
UTES
Y ARRIVAL
TURE
ARRIVAL
TURE
HOURS
UTES
HOURS
UTES
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
I CERTIFY ON MY HONOR THAT THE ABOVE IS A TRUE AND I CERTIFY ON MY HONOR THAT THE ABOVE IS A TRUE AND
CORRECT REPORT OF THE HOURS OF WORK PERFORMED CORRECT REPORT OF THE HOURS OF WORK PERFORMED
OF WHICH WAS MADE DAILY AT THE TIME OF ARRIVAL OF WHICH WAS MADE DAILY AT THE TIME OF ARRIVAL
AND DEPARTURE FROM OFFICE AND DEPARTURE FROM OFFICE
SIGNATURE SIGNATURE
CERTIFIED BY: CERTIFIED BY:
SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME