DAILY TIME RECORD DAILY TIME RECORD DAILY TIME RECORD DAILY TIME RECORD

(Name) (Name) (Name) (Name)

For the month of_____________________________ For the month of ____________________________ For the month of _____________________________ For the month of ___________________________
Official hours arrival and departure Official hours arrival and departure Official hours arrival and departure Official hours arrival and departure
Regular Days: ______________________________ Regular Days: _____________________________ Regular Days: _______________________________ Regular Days: _____________________________
Saturdays: ____________________ _____________________ Saturdays: ____________________ ___________________ Saturdays: ______________________ ___________________ Saturdays: _____________________ ____________________
A.M. P.M. Undertime A.M. P.M. Undertime A.M. P.M. Undertime A.M. P.M. Undertime
Day Arrival Departure Arrival Departure Hours Minutes Day Arrival Departure Arrival Departure Hours Minutes Day Arrival Departure Arrival Departure Hours Minutes Day Arrival Departure Arrival Departure Hours Minutes
1 1 1 1
2 2 2 2
3 3 3 3
4 4 4 4
5 5 5 5
6 6 6 6
7 7 7 7
8 8 8 8
9 9 9 9
10 10 10 10
11 11 11 11
12 12 12 12
13 13 13 13
14 14 14 14
15 15 15 15
16 16 16 16
17 17 17 17
18 18 18 18
19 19 19 19
20 20 20 20
21 21 21 21
22 22 22 22
23 23 23 23
24 24 24 24
25 25 25 25
26 26 26 26
27 27 27 27
28 28 28 28
29 29 29 29
30 30 30 30
31 31 31 31
Total Total Total Total
I certify on my honor that the above is a true and correct report of the I certify on my honor that the above is a true and correct report of the I certify on my honor that the above is a true and correct report of the 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 hours of work performed, record of which was made daily at the time hours of work performed, record of which was made daily at the time hours of work performed, record of which was made daily at the time
of arrival and departure from office. of arrival and departure from office. of arrival and departure from office. of arrival and departure from office.

VERIFIED as to the prescribed office hours: VERIFIED as to the prescribed office hours: VERIFIED as to the prescribed office hours: VERIFIED as to the prescribed office hours:

In-Charge In-Charge In-Charge In-Charge