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.., �� ■ �� Ih �.` ,Y 1 f , slnnr slur ::LUNCH HOURS HOURS REG. HOURS ` OTHOURS ` L EC� f I Sunday '.EMPLOYMENT SERVI(ES CCU r - � 7 - P.O. Box 71250 • Eugene, OR 97401 - Monday . - PLEASE PRINT > EMPLOYEE EMPLOYEE NAME SOCIAL SECURI Y NUMBER REG' HOURS OVERTIME HOURS e MPAN NAME , ` - COMPA NAME JOBS17E NAME AND /OR PO # 2-1 WE KENDI NGDATE 7 - 10 ❑ ASSIGNMENT COMPLETED RETURNING. NEXT WEEK HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. NO Tuesday .a /. •ll':) J T' ' -- I certity that ttie hours mown repTi y.totat hours worked during me week and that they were properly verfi d by the diem or by an authorized epresent Ulra. Ake ru+ff(( work stated Iryud poned es ware re to Saectemp "at the bm� otu eeravptsa far further nformation: Wednesday '� r �• AJ 1 j (!lf�, � S ur of ployee' Thursda .. CLIEN .. h ; .q n - �,f— r W ealize that to transfer one Of S school employees h, pOr 'Fritla L ' `.�-J pp ayroll requires a settlemem. See rov me for lurmcr Information. I Y l . 7. ^+ hereby car that the above hours are correct. " -Saturday X signa�t�a�afSUpe y T T AL ' TOTAL K94t A ` I J El � Hours to nearest quarter hour f C , �J s � F Tine Daie CUSTOMER COPY S Sunday EMPLOYMENT SE RVI(.ES P.O. Box 71250 • Eugene, OR 97401 Monday PLEASE PRINT EMPLOYEE NAME SOCI SECU ITY NUMBER 6o j C DMFi NAME � off Ltl�zuG JOBSI ENAME AND/0j PON Eli ENDING DATE ❑ ASSIGNMENT COMPLETED RETURNING NEXT WEEK HAVE YOU HAD AN ON THE JOB INJURYTHIS WEEK? ❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. C% NO Tuesday Wednesday Thursday Friday Saturday START STOP LESS LUNCH. REG' HOURS OVERTIME HOURS ` - COMPA NAME I ' V 2(,Lv -- JOBSI NAME AND /OR Oif EE ENDING DATE u L$yASSIGNMENT COMPLETED ❑ RETURNING NEXTWEEK HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? VES IF YES, . NOTIFY SELECTEMP IMMEDIATELY. ND Sign to Em loyeo "-- Y.Oc 7.50. V real a that to transfer one Of Selec mp's employees to our squires 'a settlement. S revers for further information. ) Friday y:(j�,,l 7 .�- - -\ `� the p yroll I a at that ab cored. ) �e S aturday —...----- P"h ' Slgnat a of Supervisor TOTAL TOTAL Hours to nearest quarter FOR OFFICE USE ONLY REG. HOURS... O T HOURS EMPLOYEE I certify that the ho rs shown represent my total hours worked during the week, and tthey wers we properly verified by the client or by an authorized represent v.Alse an y.- .��Vwroark latetl injuries were reponed to Selectemp at the rim of 'jury. Le rrlat a for further I matron. X Signal c Em mee CLIEN We a ze that to transfer one of Socatemea employees to our to I squires a settlement. See reverse tot further inlOrrnatem.I here nerL thatimabove ou are correct. S gnatur1 Of Supervisor r TOTAL TOTAL Hours to nearest goal at hour . Tge Pete CUSTOMER COPY S ELEG EM ® R START STOP LESS REG OVERTIME FOR OFFICE USE ONLY LUNC X HOURS HOURS REG. HOURS ' L OT HOURS Sunday EMPLOYMENT SERV- I(.E4.; -- P.O. Box 71250 Eugene, OR 97401+ Monday PLEASE PRINT . EMPLOYEE' EMP OYEENAME • 'SOCIAL SECURI NUMBER ` - COMPA NAME I ' V 2(,Lv -- JOBSI NAME AND /OR Oif EE ENDING DATE u L$yASSIGNMENT COMPLETED ❑ RETURNING NEXTWEEK HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? VES IF YES, . NOTIFY SELECTEMP IMMEDIATELY. ND Tuesday Wednesday • I certify that the hours shown represent my total hours worked tluring the ask and that they were properly ver by the lent or by an authorized r epresentative. Also, any work related injuries were reported to Selectemp at the time nl ry. IS var a for further Information. Sign to Em loyeo "-- CLIENT real a that to transfer one Of Selec mp's employees to our squires 'a settlement. S revers for further information. ) Friday y:(j�,,l 7 .�- - -\ `� the p yroll I a at that ab cored. ) �e S aturday —...----- P"h ' Slgnat a of Supervisor TOTAL TOTAL Hours to nearest quarter hour.. Title 'ate CUSTOMER COPY . ,