Time Adjustment Form

Time Adjustment Form

Because you didn't clock out (or in) you have to complete this form.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
I forgot to...
Clock In Date and Time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Clock Out Date and Time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Reason for Not Properly Clocking in or out.
By signing below you first attest that all the information is true. You also understand that erroneous time records submitted through this manner may take one additional pay period or more to be procesed. It is in your best interest to ensure you are utilizing the proper timeclocking solutions provided.
Signature
Self Initiated Steps To Fix.
Should be Empty: