This form may be completed electronically, or printed and completed in ink. All boxes that are shaded will automatically calculate when the form is completed electronically.
- Employee Name: Record your last name (comma) first name and middle initial. Example: Doe, John B
- Empl ID: Enter your 8-digit, numeric identification code. Example: 01020000
- Pay Period Begin and End Date: Record the dates of the pay period covered on this form. Example: 8/19/01 to 9/1/01
- Note: If you complete this form electronically, enter the begin date and the end date and all the dates associated with each day of the pay period will auto-populate.
- Week 1 and Week 2: Write in the actual times in and times out for each day you worked. Example: Time In 7:30 am (DO NOT USE PERIODS), Time Out 11:35 am, Time In 12:35 pm , Time Out 4:30 pm. NOTE: When completing the time sheet electronically, times recorded must include "am" and "pm" and there must be a space between the time and the "am" or "pm" designation, so that HOURS WORKED field will calculate AUTOMATICALLY.
- Hours Worked: For each day add up all the hours recorded in each column and record the total. Based on the conversion chart at the bottom of the form, any partial hours worked need to be converted to tenths of an hour. NOTE: When you complete this form electronically, this field will calculate for you, if the times in/out have been properly formatted.
- Total Hours First Week and Second Week: Add the hours recorded for each day of the week. If the total is 40 hours or less, record that amount as Total Hours First (Second) Week (Regular). If the total exceeds 40, record 40 hours as the Total Hours (Regular) and hours in excess of 40 in the block labeled "Overtime." NOTE: These fields will calculate automatically, when you complete this form electronically.
- Totals for Biweekly Pay Period: Add the total hours worked in the first week to the total hours worked in the second week. This amount should be recorded as biweekly total (Regular). Total all Overtime worked and record in total biweekly (Overtime).
- Shift Differential: Record any hours worked that are eligible for shift differential (regular and/or Overtime) in the appropriate row. DF2 =2nd shift (2 pm-10 pm) DF3 = 3rd shift (10 pm-6 am) See theHuman Resource Policy HR213.
- Employee Signature: Sign your name in the space for Employee's Signature.
- Supervisor Signature: Give completed Time Record to your supervisor. The appropriate supervisor must review and sign the Time Record, certifying its accuracy. Any changes made to this form must be initialed by both the employee and the appropriate supervisor.
Reviewed 2019-08-05