Time Clock Correction Form

Time Clock Correction Form

Employees: If you failed to clock in/out or your time needs a correction, please complete this form before the payroll period ends. Use a separate form for each date. Enter the ACTUAL time you arrived or left, NOT your scheduled time.
Time Clock Information
Name*

First NameLast Name
Date of Shift*

MonthDayYear
Date
Please note: you only need to add any missing punch(s), not all 4 punches for the day.
Arrival Time for the day

:HourMinutesAM/PM Option
Time punch out for lunch

:HourMinutesAM/PM Option
Time punch in from Lunch

:HourMinutesAM/PM Option
Departure time for the day

:HourMinutesAM/PM Option
Employee Approval: I certify that the information reported above reflects the accurate correction needed for Payroll.
Signature

Clear
Should be Empty:

Please note: you only need to add any missing punch(s), not all 4 punches for the day.