DAILY TIME RECoftD DAILY TIME RECORD

NAME
For the month of For the month Of
Office lJours for Arrival (Regular Days) and Departure Office Hours for Arrival (Regular Days) and Departure
i,ififyfi4`t_saturty_.surif,a¥ Nl{`jke{)Ai_Saturday lliNr)&t

DATE AM PM DATE AM PM
Jthul DqJl,fro AJ"\al Dcprrtue AJn\|l Dq- Am,4l DcpeJbe
I I
2 2
3 3
I 4
S I S 1

6
7 1

7
1
I
8
I

9
I.
„ 10 i

11 (
12
12
1}
13
I,
14
|S
:I,
„5
17
I „6
17 I

I,
I

18 I

I,
19
2® i I

20
21 i
21
22
22
23 I
23
2, I

2,
25
25
26
26
27
27
28
:z8
I

2,
29
sO
ae
31!
31 i

I certify on my honor that the above is triie and I certify on my honor that the above is true and
correct report of the hours Of work performed .ecord correct report of the hours of work performed record
of which was dally time of arrival at and departure of which was daily time Of arrival at and departure
from office. from office.

Verified as to the prescribed office hours Verified as to the prescribed office t`ours

PCAPT ROMEO N NAUSISA, Rot

C]ugter Head 3
PCAPT ROMEO N NAUSISA, Rot
Clu9t.r l]em3