DAILY TIME RECORD

-----o0o----- (Name)

For the month of __________________________

(Name) Official hours for Regular ____________
arrival and days
For the month of __________________________ departure Saturdays ____________
Official hours for Regular days ____________
arrival and Saturdays ____________ A.M. P.M. Undertime
departure Day Depar- Depar- Min-
Arrival Arrival Hours
ture ture utes
A.M. P.M. Undertime 1
Day Depar- Depar- Min- 2
Arrival Arrival Hours
ture ture utes
3
1 4
2 5
3 6
4 7
5 8
6 9
7 10
8 11
9 12
10 13
11 14
12 15
13 16
14 17
15 18
16 19
17 20
18 21
19 22
20 23
21 24
22 25
23 26
24 27
25 28
26 29
27 30
28 31
29 Total
30
31 I certify on my honor that the above is a true and correct
Total report of the hours of work performed, record of which was
made daily at the time of arrival and departure from office.
I certify on my honor that the above is a true and correct
report of the hours of work performed, record of which was
made daily at the time of arrival and departure from office.
VERIFIED as to the prescribed office hours:

VERIFIED as to the prescribed office hours:

In Charge

In Charge

DAILY TIME RECORD

-----o0o-----