Payroll No. 464 ● Weekly Employee Hourly Time Sheet
CD
TO BE FILLED IN BY
PAYROLL DEPT:
JSN
Name (Last)
(First)
REFERENCE NUMBER
EVENT CODE
Every consecutive 5-hour period must include ½ hour for lunch.
Every consecutive 7-hour period must include 1 hour for lunch.
Day of week
Month
DAT E
Day
IN
Out
BREAK
In
DEPARTMENT CODE
0100
OUT
Work Hours
1651
Shift Hours
2850
Annual
Leave
*2651
**2652
Sick Leave
Employee
Initials
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Total Work Hours
Total Annual Leave Hours
Total Sick Leave Hours
Grand Total
FOR PAYROLL USE ONLY
RATE
*
These hours have not been submitted for payment on any other payroll nor on any other
timesheet submitted.
Employee Signature
Date
Supervisor Signature
Date
Key Entry Operator
Date
Documented Sick Leave
** Undocumented Sick Leave
10/05