Time Adjustment Form
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
First Name
Last Name
Specify what the time adjustment is for:
clock in / clock out
break
Time in / break
Hour Minutes
AM
PM
AM/PM Option
Time out / break
Hour Minutes
AM
PM
AM/PM Option
Reasoning for time adjustment
Started Shift Earlier
Stay past scheduled shift
Forgot to clock-in / Late
Leave earlier than scheduled shift
Covering Shift
Personal Emergency
Other
Signature
Continue
Continue
Should be Empty: