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