APOLLO CAREER CENTER ADULT EDUCATION PAYROLL VERIFICATION – 2012-2013
SS # LAST 4
PROG #
NAME:
COURSE TITLE:
XXX-XX-
INSTRUCTIONS: Insert number of hours worked in each appropriate date block. Insert total hours for pay period and insert your initials in appropriate
block.
* This asterisk below indicates End of Pay Period
Turn pay sheet in to your designated person by 4:00 p.m. the next Monday or it will go on next pay.
January 2013
Sunday
Monday
Tuesday
Dec 30
Dec 31
6
13
20
7
14
21 Holiday
1 Holiday
8
15
22
Monday
Tuesday
Sunday
Wednesday
2
9
16
23
Thursday
3
10
17
24
Wednesday
Thursday
Jan 27
Jan 28
Jan 29
Jan 30
Jan 31
3
10
17
4
11
18 Holiday
5
12
19
6
13
20
7
14
21
Sunday
Monday
Tuesday
Wednesday
Thursday
Feb 24
Feb 25
Feb 26
Feb 27
Feb 28
3
10
17
4
11
18
5
12
19
6
13
20
7
14
21
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
4
5
11
12*
18
19
25
26*
February 2013
Friday
Saturday
1
2
8
9*
15
16
22
23*
March 2013
Friday
Saturday
1
2
8
9*
15
16
22
23*
April 2013
Friday
Saturday
Mar 24
Mar 25
Mar 26
Mar 27
Mar 28
Mar 29 Holiday
Mar 30
Mar 31
1
8
15
22
2
9
16
23
3
10
17
24
4
11
18
25
5
12
19
26
May 2013
6*
13
20*
27
7
14
21
Sunday
Monday
Tuesday
April 28
April 29
April 30
5
12
19
6
13
20
7
14
21
Sunday
Monday
Wednesday
1
8
15
22
Tuesday
Thursday
2
9
16
23
Wednesday
Thursday
Friday
3
10
17
24
June 2013
Friday
May 26
May 27 Holiday
May 28
May 29
May 30
May 31
2
9
16
23
3
10
17
24
4
11
18
25
5
12
19
26
6
13
20
27
7
14
21
28
PAYROLL OFFICE USE ONLY:
I:\Adult_Staff\ISO\Forms
EMPLOYED________
Revised: 12/11/2012
Saturday
4*
11
18*
25
Saturday
1*
8
15*
22
29-30*
Total hours
this pay period
Instructor
Initials
Supervisor
Initials
Instructor
Initials
Supervisor
Initials
Instructor
Initials
Supervisor
Initials
Instructor
Initials
Supervisor
Initials
Instructor
Initials
Supervisor
Initials
Instructor
Initials
Supervisor
Initials
*14
*15
Total hours
this pay period
*16
*17
Total hours
this pay period
*18
*19
Total hours
this pay period
*20
*21
Total hours
this pay period
*22
*23
Total hours
this pay period
*24
*25
*26
CERTIFIED_________
PAY RATE____________
AEF0049 (10)