(Name)

For the month of ___May 20-31__________20_19

Official hours for arrival : Regular days-8:00-12:00/1:00-5:00
And departure
: Saturdays/Sundays- AS NEEDED

D AM PM UNDERTIME
A ARRI- DEPAR- ARRI- DEPAR-
Hours Minutes
Y VAL TURE VAL TURE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18 S A T U R D A Y
19 S U N D A Y
20 7:40 12:20 1:00 5:05
21 8:00 12:00 1:00 5:00
22 8:00 12:01 12:55 5:14
23 8:00 12:05 12:40 5:14
24 8:00 12:08 12:50 5:02
25 S A T U R D A Y
26 S U N D A Y
27 8:00 12:08 12:40 5:01
28 8:00 12:02 12:52 5:15
29 7:59 12:05 12:37 5:03
30 8:00 12:06 12:42
31

Total =

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 at and departure from
office.
Verified as to the prescribed office hours.