New Search
~tLC1 ~1~ <br />EMDLOYME NT SEAYd(ES <br />P.O.Box 71250 • .Eugene, Od 97401 <br />PI FASFPRINT <br />~f, <br />Suntlay <br />. 'Monday ~7' „ <br />Tuesday '~: (};) ~ .g0~ <br />Wednesday 7 ~ } '~ `.9 Q <br />Thursday 7,~d:J~.(J~ <br />~..X (J!_ <br />Frlday t ~-. s <br />$aturtlay <br />HOURS.I nouRS- <br />.- <br />'1ryr S <br />5 r/,}5 <br />J U <br />-S ~l,s <br />e` ~.~ <br />.% - <br />~' EMPLQYEE NAM <br />SOCIAL SECURITY NUMBER <br />f..0; I <br />~OMPANY NAME <br />' JOBSITE NAME AND/OR PO# <br />/ I ~ ; ~. <br />WEEK ENDING DATE <br />^AGSIGNMENT COMPLETED RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JORINJURV THIS WEEK7 <br />^YES IF YES, NOTIFY SELECTEMP IMMEDIATELY <br />L-L' NO <br />SELECT P <br />EMDLOYMENT SERVICES <br />P.O. Box 71250-• Eugene, OB 97401 <br />PI FASF PRINT <br />Hours fo nearest quarter hour. <br />EMPLOYEE <br />I certify Ihat Iha hours shown represent my tolaldodrs wo ketl during the <br />week antl That Ifieywere p op rly ver t tl by the client or Cy en authorizetl <br />represenlaGVe Also any work related nI res were reporletl fo Seledamp <br />0 al the Ome of njury See reversal Wfthe nlormalo <br />wGli]C,~~~ ~_..1f ~ rrr;~; <br />' ~ Slgnature9 Employee, <br />CLIENT '~ <br />We realize that io transfer one of Selecternp's empleyeesb our <br />payroll regm es a selllemenf. See rev rseaor further Information. I <br />hereby certl that [D¢above heurs ar correct.; <br />r- ' %; I <br />X ,.-.. <br />Sllig lw111 l~ul/rt.o~f /Supervisor s~ 1 ~ ~+'~ I~ <br />TOTAL Y'`1 r'•1\ Sl~.'JJ '. 1. ~. +©. ~~IV <br />Ltle 1 Dale <br />~~ CUSTOMER <br />S Suntlay <br />Monday <br />I EMPLOYEE NAME <br />~~tCx~ ~ U~c~ <br />SQCIAL SECURITY NUMBER <br />~~ G i 1 <br />y COfy1PANY NAME <br />'JOBSITE N `ME AND/OR PO# <br />s,Cl E <br />WEEK ENDING DATE <br />~ ~ t / I r, <br />^ASSIGNMENT COMPLETED LU RETURNING NE%T WEEK <br />HAVE YOU HAD AN ON THE JOe INJURY THIS WEEK? <br />^ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. ~ <br />©' NO <br />SECT <br />EMDLOYMENT SERVICES <br />P.O. Box 71250 • Eugene, OR 97401 <br />of enee ootnlr <br />Tuestlay <br />Wetlnestlay <br />Thurstlay <br />Fdtlay <br />$atuNay <br />START STOP LESS <br />LUNCH REG" ' <br />HOURS OVERTIME <br />HOUR&. <br /> <br /> <br /> <br />~:GL. 3'.3~ , , g' <br />-~,~:, 3.-:.7 :s ~. <br /> <br /> <br />rux urric>H ua <br />HOUR& ~ O.T. <br />EMPLOYEE <br />Leerti(y Iha[ the hours shown represent my total hours warkatl tluring the <br />week antl that Ihey were properly vedlietl by the diept or by an amhotlzed <br />representative Also, any,wprk IFletetl - j - s re reported to Selectemp <br />et the I me of nlury See reverse fOr lurlner nformalion. <br />x~G 4~'~ ~_, ~;51'tc~ <br />Slgnatu~LEmployee <br />CLIENT <br />Werealize that. to irarisier one of Selebfemp's employees to our <br />payroll requires a settlement. See reverse for further Iniormation.t <br />hereby certify [ f iha shove hours are correct. <br />X n -, c~~__._ <br />Slgnature ISUpen sor ~ j <br />AL~ TOTAL ~ ~7 ::, <br />Hours to nearest quarter hour. Tlla Da[e <br />Suntlay <br />%;, Mandey <br />EMALE}YEE NA E <br />. Y <br />~tiC_ I`~ ~ ~~ ~~ f <br />SOCIAL$FPCU_RITV NUMBER <br /> <br />,. ~ COMPANY NAME <br /> <br />JOBSITE NAME AND/OR PO# <br />4. <br />' <br />I <br />j <br />.~ <br />WEEKENDING;DA7E <br /> <br />f <br />^.ASSIGNMENT COMPLETED LJa RETURNING NE%T WEEK. <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />^ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />CrA.NO <br />Tuesday <br />wednestlay <br />Thurstlay <br />Fndey <br />Seturilay <br />START STOP LESS -~ <br />LUNCH, ''REO <br />HOURS OVERTIME <br />HOURS' <br /> <br /> <br />c_~ ~, <br />w <br /> <br />? ~ br ~.~~'' ~' <br />J c1 <br />~"} , . t • <br /> <br /> <br />Hours to nearest quarter hour. J~ I <br />CUSTOMER COPY <br />FOR OFFICF. USE ONLY <br />REG. HOURS - ~ O.T. HOURS <br />' EMPLOYEE <br />I cerlily That the houisshbwn represent myaolal hours worked tludng the <br />eek and Ihat they were properly ve i edW the client or by an authorized <br />r¢prese tat ve: Also any work elated lryu re repoU¢d to Seledemp <br />I th t e of nlury See, ~ arse rorfq her ln~ ~ Rion. <br />x ~ fi =k . f ~ ~t ~ ~`~(I <br />Signature mpoyee' <br />CLIENT <br />_ Wa realize that fo transfer oneob Selectemp's employees to our <br />payroll requires a settlement. Sae reverse for further Inlormation. I <br />hereby certify that the above hours re correct. <br />Data <br />