Week Ending_______________________

Name	Department	Shift	File #
Employee #	Social Security #		Payroll Class

	Morning Hours		Afternoon Hours		Overtime Hours		Office Use Only
	Time In	Time Out	Time In	Time Out	Time In	Time Out	Regular	Overtime
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Totals

 Signatures

Employee	Date	Department Supervisor	Date
Supervisor	Date	Payroll Department	Date