Last Name `First Name MI For the month of ________________ Official Hour for arrival and departure For the month of ________________ Day Morning Afternoon Official Hour for arrival and departure IN OUT IN OUT Day Morning Afternoon 1 IN OUT IN OUT 2 1 3 2 4 3 5 4 6 5 7 6 8 7 9 8 10 9 11 10 12 11 13 12 14 13 15 14 16 15 17 16 18 17 19 18 20 19 21 20 22 21 23 22 24 23 25 24 26 25 27 26 28 27 29 28 30 29 31 30 Total - - - - - - - - - - - - - - - - - - - - - - - - 31 I CERTIFY that the above is a true and correct Total - - - - - - - - - - - - - - - - - - - - - - - - report of the hours of work performed, record which I CERTIFY that the above is a true and correct was made daily at the time of arrival and departure. report of the hours of work performed, record which was made daily at the time of arrival and departure.