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. e ■ . ` slur LUNCH HOURS . XOURS" .,. <br />I I , Y e '.REG. HOURS - O.T HOURS <br />Sunday <br />~ EMPLOYMENT SERVICES' " <br />r <br />P.O. Box 71250 • Eugene, OR 97401 1 Monday 3, U:� '•S :�'� <br />PLEASE PRINT <br />EMPLOYEE NAME <br />STOP <br />SOCIALL SE <br />URITY NUMBER <br />8 <br />_ <br />agT <br />COMPANY NAME <br />'Thursday <br />JOBSITE NAME AND /OR POW <br />iffil WE E K ENDINGDATE <br />0 <br />❑ ASSIGNMENT COMPLETED ETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />YES IF YES; NOTIFY SELECTEMP IMMEDIATELY <br />NO <br />Tuesday <br />". <br />Wednesday <br />STOP <br />.- CUSTOMER. COPY <br />..., ....... _...... <br />.. ... _. <br />_ <br />agT <br />that the Whs ehowd repress t y total huurs,rimhed during the <br />I tartly h <br />week; and that Ivey we properly vanlleJ by the client or by an autnorized <br />represent : Nao, any work relemtl injuries were reported to Seleilemp <br />et the li Iniu r rsalortWhadhermat.n. <br />'Thursday <br />yq�' <br />; ri <br />FOR OFFICE USE ONLY <br />sroP <br />^_ <br />Thursday <br />`�. <br />_ S <br />S lur of mPl e <br />~� <br />C NT <br />Ride Y �.� <br />�.co <br />•, <br />ae that to V 0, on e S for employees to our <br />it r <br />s Payroll req fires a file settlement. See a sea arse for furInformation. er Information. <br />�.� 'herb ce Etna ab m } correct. <br />Saturday �` <br />•"_ <br />`._ <br />X <br />^ S19naie of SupsrlSet .. <br />. <br />Hours to nearest hour. <br />TO AL TOTAL <br />I (f <br />O.T HOURS <br />quarter <br />Tale Date , <br />... <br />STOP <br />.- CUSTOMER. COPY <br />..., ....... _...... <br />.. ... _. <br />_ <br />agT <br />repreaentatlw: Also, any work related Injuries were reported to Seledemp. <br />" at the Him, - mu lRyererse for furore i. matlon. <br />'Thursday <br />yq�' <br />; ri <br />FOR OFFICE USE ONLY <br />sroP <br />LESS <br />RE <br />S ELEGEMP <br />' <br />End ` <br />a1' <br />".5 <br />P <br />ro ze that to renstar.ono�of Selectemp's employees to our <br />p Y ragmras a seKlemonL Sea reverse for further Information: I' <br />h certl that the ebwe hdu are comecl:. <br />/ <br />LUNCH <br />HOURS <br />H oveRnME <br />OURS <br />REG. HOUR& <br />O.T HOURS <br />Sunday <br />0 <br />_ F <br />" <br />.:. <br />EMPLOYMENT SE RVI(ES <br />'- - <br />P.O. Box 71250 • Eugene, OR 97401 <br />. Monday <br />F,1 <br />t- k 0i <br />tl <br />Tu9 y ada <br />(�( ^/ <br />�'a+" <br />�� <br />o <br />EMPLOYEE <br />1 conify that the hours shown represent my total hours wanted dump the <br />PLEASE PRINT <br />week, and that they wom properly wrllied by the cllerf or by an authorized <br />EMPLOYEE NAME <br />J bz. <br />SOCIAL SE•CCUURRIIITT`YY N M_ BER <br />. COMPANYNAME <br />IT ?- _GF .CVC <br />WEEK ENDING DATE <br />h ' - 6 /10 <br />❑ ASSIGNMENT COMPLETED .RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />(�. NO <br />Wednesday <br />STOP <br />LESS <br />LUNCH. <br />REG 'OVERTIME <br />HOURS <br />HOURS <br />repreaentatlw: Also, any work related Injuries were reported to Seledemp. <br />" at the Him, - mu lRyererse for furore i. matlon. <br />'Thursday <br />yq�' <br />; ri <br />Gj. <br />sgn pOYeo <br />- <br />CLIENT <br />' <br />End ` <br />a1' <br />".5 <br />P <br />ro ze that to renstar.ono�of Selectemp's employees to our <br />p Y ragmras a seKlemonL Sea reverse for further Information: I' <br />h certl that the ebwe hdu are comecl:. <br />..` <br />/ <br />Saturday L <br />Hour; to nearest quarter <br />hour <br />TOTAL <br />'Al <br />X (I <br />Slgrtetu of SUperWSOr ' <br />TOTAL �I �y <br />D ata y �MI y � � rta (o Tlla <br />CUSTOMER COPY <br />SELECTEMP Sunday <br />EMPLOYMENT SERVICES <br />P.O. Box 71250 • Eugene, OR 97401 Monday. <br />PLEASE PRINT <br />EMPLOYEE NAME <br />CC (" tti(CTZ <br />SOCIAL SMU BER. <br />C MP NV NAME "NAME " <br />JOBSITENA E AND /OR POW <br />E, 7 DATE <br />t0 <br />❑ ASSIGNMENT COMPLETED RETURNING NEXT WEEK <br />HAVE YOU HAD AN ONTHE JOB INJURYTHIS WEEK? <br />YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />NO <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />START <br />STOP <br />LESS <br />LUNCH. <br />REG 'OVERTIME <br />HOURS <br />HOURS <br />Y <br />33'.M.S�. <br />FOR OFFICE USE ONLY <br />RE G. HOURS O.T. HOURS <br />EMPLOYEE <br />I earthy that the hours shown represent my total hours werked dung the <br />we ek, and that hey were pheeedy by the deem or by an auhorized <br />rear een t e: Alan��,,9A y w k related lui es ware reported to Selectemp <br />atilia @e linju y'Sa roetorfurther information. <br />X <br />S azure' Employee <br />CLIE� T <br />We e Mtransfer one o Solectemp <br />ize that to t's employees to our. <br />R ell requires a settlement. See reverse for funh,a information. I <br />eby certify hot the above / hours are gonect, - <br />X <br />Sgnaturelof Supervisor <br />I TOT,[rL TOTAL xfl�1"./11.1 4 i S( F - z q - /C <br />Hours to nearest quarter hour. T Ttle Date <br />CUSTOMER COPY <br />