Missed Punch Form
Report missed time clock punches and request timesheet corrections. Fields default to optional unless clearly required.
Employee Identification
Employee Name
*
First Name
Last Name
Client Name
*
First Name
Last Name
Timesheet/Pay Period Context
Pay Period Start Date (Sunday's Date)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pay Period End Date (Saturday's Date)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Regular Schedule
*
Missed Punch Details
Date of Missed Punch
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Punch
*
Please Select
Missed Clock In
Missed Clock Out
Missed Lunch Out
Missed Lunch In
Other
Correct Time In
*
Hour Minutes
AM
PM
AM/PM Option
Correct Time Out
*
Hour Minutes
AM
PM
AM/PM Option
Reason for Missed Punch
*
Totals / Timesheet Impact
Attach supporting documentation
Upload a File
Drag and drop files here
Choose a file
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of
Acknowledgments & Approvals
Employee Acknowledgment
*
I certify that the information provided is accurate and reflects my actual hours worked.
Employee Signature
*
Date Submitted
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supervisor/Scheduler Notified
*
Yes
No
Supervisor Comments
Administrative Use
Payroll/HR Notes
Processed By
Date Processed
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: