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F F p ® ®p�1��� <br />i � Y � , � �■ ■� alwnl ?ii LUNCH :.HOURS. HOURS. —...- <br />L REG HOURS'. <br />Sunday <br />EMPLOYMENT SEAVI(ES <br />P.O. Box 71250 •Eugene, OR 97401 Monday 7' <br />PLEASE PRINT EMPLOYEE <br />EMPLOYEE NAME <br />� G 61& <br />SOCIAL URITV NUMBER <br />IH <br />OM <br />PANY NAME <br />'I 01f JOBSITE NAME AND/OR PO#. <br />WEEK ENDING: DATE <br />❑ ASSIGNMENT COMPLETED RETURNING. NEXTWEEK <br />HAVE YOU HADAN ONTHEJOB INJURYTHIS WEEK? <br />;U,*ES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />LJ NO <br />Tuesday <br />Wetlnestlay <br />`7 <br />i( <br />3rl 1 <br />5 <br />- <br />: I OsnhI, the the hours shown represent my total hours worked during the <br />week andthat they were properly vented by the client or by an sutbonesd <br />representative. Also, any work related injuries were reported to Selectemp <br />et the t of injury See revemeforfutlher frmdlion. <br />,. <br />� � <br />�r <br />G ✓ , <br />�(. <br />� <br />FSTAR <br />(� <br />X &r` 0 <br />Thursday <br />-' 7 <br />3 A ) <br />; ` <br />C J� <br />/ y <br />Signature Employee -' <br />- <br />�- <br />� <br />0 <br />CLIENT <br />Friday <br />>...x <br />5 �J <br />5 <br />War ealae that to transfer one of r everse for em to our <br />. payro ll requir s a settlement See revarse9or further er er information. 1' <br />"herebycerti <br />Saturday <br />// <br />U <br />hattheabove hours re caged. <br />r 11 <br />Saturday <br />'AG'L <br />r S gnat, a of Sop ersa <br />v ' or r <br />to nearest hour. <br />z„l <br />TOTAL <br />TOIL <br />sieneju(n�rof s sor <br />1`�� 7 v C . k., 1 — Y ':S — IO . <br />Hours to nearest quarter hour <br />1 -)J! ! V <br />Tits Data <br />CUSTOMER COPY <br />E LEG <br />START STOP OVERTIME FOR OFFICE U$E ONLY <br />f WNCH HOURS HOURS <br />- HEG HOURS "- D.T. HOURS <br />EMP <br />Sunday <br />E MP L0YME NT SE'RVI(E3 <br />P.O. Box 71250 Eugene, OR 97401 C - Monday - -_ <br />PLEASE PRINT <br />EYPLOYEE NAME <br />SO L- SEDUTTY NUMBER. <br />CO ANY NAME <br />�L.. -!� G- <br />JOBSITE NAM&ANDIOR PO# <br />WE ENDING. DATE <br />L ASSIGNMENT COMPLETED RETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY, <br />C NO <br />Tuestlay.. <br />:d <br />Wednesday <br />`7 <br />LESS <br />LUNCH <br />.� <br />` <br />J <br />J <br />EMPLOYEE' <br />1 sediry thaUhe hours shown represent my total ho.. worked during the <br />ask. and thotthey were plparly verfed by the client or by an authorzetl <br />representative. Also any work related injur were reported to Selech mp <br />atthe tlm of inju ee eve se for turlhennformation: <br />' <br />�r <br />G ✓ , <br />�(. <br />� <br />FSTAR <br />(� <br />X <br />Thursday <br />-' 7 <br />^/ o` <br />— r <br />/ y <br />Srgnature ofE ployea' <br />�- <br />� <br />0 <br />CLIENT <br />Fndey <br />. 36 <br />- ?,5 <br />We realrze that to transfer one Of Seledempe employees to our <br />payroll requires a settlement. See everse for further information. I. <br />hereby cer that th e also yye <br />/rb'Our. re correct. <br />Saturday <br />5, <br />U <br />{ <br />'AG'L <br />r S gnat, a of Sop ersa <br />v ' or r <br />to nearest hour. <br />z„l <br />T T� <br />.Hours <br />quarter <br />Title .. Data <br />CUSTOMER COPY .. <br />SELEGEMP Sunday <br />1 <br />EMPLOYMENT SERV I.(.ES 'l- <br />P.O. Box 71250 • Eugene, OR 97401 Monday <br />PLEASE PRIN ` <br />EMPLOYEE NAME " <br />SOCIALS URITV NUMBER <br />�l <br />C e MPANY NAME <br />OBSITE NAME AND /OR PO# <br />WEEK ENDING DATE <br />tli - 10 <br />❑ ASSIGNMENT COMPLETED RETURNING NEXTWEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />ES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />�NO <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />FOR OFFICE USE ONLY <br />.REG HOURS � OT HOURS EMPLOYEE- EMPLOYEE- <br />I certify lost the hams show, represent my.total hours worked dur the <br />weak and that they eregroperly verged by thedienturbyanaudanzed <br />representative. Also any ark related in juries went reported to Seledtemp <br />at the th l lntry — See — reverse for orNer information. <br />Signature of Employee - <br />CLIENT <br />We realaa that to transfer one of Selectfi employees to our <br />Payroll requires settlement. See reverse tot further information. I <br />here Vito Qy that the above th a correct. ' <br />X 7 - <br />Slgnaphe of Supervisor <br />.'T TOTAL - <br />Hours to nearest quarter hour. VV N `J Title Date <br />l9IQ1111ful CfIPV <br />STOP <br />LESS <br />LUNCH <br />REG <br />HOUfl8 <br />OVERTIME <br />HOURS <br />FSTAR <br />T5 <br />TO <br />�- <br />� <br />0 <br />3 <br />. 36 <br />- ?,5 <br />'3 <br />�� � <br />5, <br />U <br />FOR OFFICE USE ONLY <br />.REG HOURS � OT HOURS EMPLOYEE- EMPLOYEE- <br />I certify lost the hams show, represent my.total hours worked dur the <br />weak and that they eregroperly verged by thedienturbyanaudanzed <br />representative. Also any ark related in juries went reported to Seledtemp <br />at the th l lntry — See — reverse for orNer information. <br />Signature of Employee - <br />CLIENT <br />We realaa that to transfer one of Selectfi employees to our <br />Payroll requires settlement. See reverse tot further information. I <br />here Vito Qy that the above th a correct. ' <br />X 7 - <br />Slgnaphe of Supervisor <br />.'T TOTAL - <br />Hours to nearest quarter hour. VV N `J Title Date <br />l9IQ1111ful CfIPV <br />