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t ■ ° Sunday - - .REG HOURS? OT HOURS E M P L 0 Y M E N T S E R V I( ES P.O. Box 71250 • Eugene, OR 9741)1 Monday, - - 'EMPLOYEE Tuesd , PLEASE PRINT Y Lbar Ilia' ilia hours shown represent y total hours warbad'during the wreak d Ih I IM1 1 EMPLOYEE NAME ' l SOCIAL SECURITY NUMBER COMPANY NAME WEEK ENDING DATE ' I � ! G ASSIGNMENT COMPLETED 0' RETURNING NEXT WEEK HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? El YES IF YES, NOTIFY $ELECTEMP IMMEDIATELY. NO " p CUSTOMER COPY pp ®w s an a eywere propehy venlled by,lhe dlent erMan authonzed re prasadte�rve. Ales, any work relatetl infurles were reported to Seleclemp oH FOR OFFICE USE ONLY LESS R Wednesday ^. a1 the lima of inlury.Sea reverse for further irradiated. \(\ L M / sTAflT S STOP - HOURS H S gnalureof Emplgee - Thursday O HOURS " CLIENT- . We' realize that to transfer one .1 Selectemp's emplayees to our v C - Mimi requires a sediment. See raweme for further Information. I ' beraby certify rat the abi ho rs ere rrect. X sawmav �', 'SlgnaW f erviso ' .. TOTAL TOTAL . Hours to nearest quarter Hour. - Tid � Dale " p CUSTOMER COPY pp ®w s oH FOR OFFICE USE ONLY LESS R REG o Le C \(\ L M / sTAflT S STOP L HOURS H HOURS OURS R REG. HOURS O O HOURS \ Sunday E LOYMENAT S. FR VICES - - P.O: Box 71250 •. Eugene, OR 97401 ' '.Monday, 7 7 j j - -7 r EMPLOYEE. PLEASE PRINT Tuesday f f v L - - ., ., � �� " Corby I t t the hours shown repress Vmy total boom worked during the at the were rt r ed by the client or an thorb EMPLOYEE NAME _ SOCIAL'SECURITY.NUMBER i� COMPANY NAME WEEK ENDING DATE El ASSIGNMENT COMPLETED Q RETURNING NEXT WEEK HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? El YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. ® NO Y p r a au il e rep ee i re plea eny wo k r le nlunes were reported to So octemp �.' atlhatl of inlury. See mrerse rrtharnf melon " Wednesday 7 UI! _ ix i•7, :�:g slgnawre of Employee Thursday f �G . - 9k,' CLIENT -We realrze ihat,to lrarafer one of, Selectemp demployaes to our Friday 1 ' l� � (.P„ Ppaayyroll requires a settlement See reverse for further Information , harehy cart ,that Ilia atiove um m omeq Saturday Signatu of Spa /rv`mor " TOTAL TOTAL t Hours to nearest quarter hour. V Tide Data SE L E( TE CUSTOMER COPY OVERTIME ®� � STAflT STOP LESS REG EflTIME FOR OFFICE USE ONLY I �I LUNCN HOURS, HOURS" "' REG HOURS "N , O T HOURS Sunday E'MPL0YMENT SE RA I.(E S' P.O. Box 71250 • Eugene, OR 97401 Monday - ;,.`},' 3 - EMPLOYEE Tuesday �, ! I 1 Carty ma}(�1the houre d during the snoan represent In total hours weaned PLEASE PRINT y ' } weekend? Ilhey were properly vaM1leG 6ylha elect or. by an euthatlzed EMPLOYEE NAME r SOCIAL SECURITY NUMBER COMPANY NAME i - 1 . WEEK ENDINGDATE ❑ ASSIGNMENT COMPLETED O RETURNING NEXT WEEK HAVE YOU HAD AN ON'rHE JOB INJURYTHIS WEEK?' ❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. El NO _ "represents Je.Aleo eny work relahxAdjuIiea were reported to Selectemp at the hand Injury See reverse for W 1M1er rdonneaon., Wednesday .'r:o t) Signature of of Empl�� Thursday 3 1J ! CLIENT ' We- bunize' that to transfer one of Selech mp's employees to our 'J J F' payroll requires a settlement. .See : rewrsefor further Information. I • Friday i l .�: :hereby car that the above hours era mi 'Saturday " ' X ''� r• - - Signal ra of Supervisor TOTAL TOTAL Hours to nearest quarter. hour. HC?.j - Title Date CUSTOMER, COPY SE L E( TE CUSTOMER COPY OVERTIME ®� � STAflT STOP LESS REG EflTIME FOR OFFICE USE ONLY I �I LUNCN HOURS, HOURS" "' REG HOURS "N , O T HOURS Sunday E'MPL0YMENT SE RA I.(E S' P.O. Box 71250 • Eugene, OR 97401 Monday - ;,.`},' 3 - EMPLOYEE Tuesday �, ! I 1 Carty ma}(�1the houre d during the snoan represent In total hours weaned PLEASE PRINT y ' } weekend? Ilhey were properly vaM1leG 6ylha elect or. by an euthatlzed EMPLOYEE NAME r SOCIAL SECURITY NUMBER COMPANY NAME i - 1 . WEEK ENDINGDATE ❑ ASSIGNMENT COMPLETED O RETURNING NEXT WEEK HAVE YOU HAD AN ON'rHE JOB INJURYTHIS WEEK?' ❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. El NO _ "represents Je.Aleo eny work relahxAdjuIiea were reported to Selectemp at the hand Injury See reverse for W 1M1er rdonneaon., Wednesday .'r:o t) Signature of of Empl�� Thursday 3 1J ! CLIENT ' We- bunize' that to transfer one of Selech mp's employees to our 'J J F' payroll requires a settlement. .See : rewrsefor further Information. I • Friday i l .�: :hereby car that the above hours era mi 'Saturday " ' X ''� r• - - Signal ra of Supervisor TOTAL TOTAL Hours to nearest quarter. hour. HC?.j - Title Date CUSTOMER, COPY EMPLOYEE NAME r SOCIAL SECURITY NUMBER COMPANY NAME i - 1 . WEEK ENDINGDATE ❑ ASSIGNMENT COMPLETED O RETURNING NEXT WEEK HAVE YOU HAD AN ON'rHE JOB INJURYTHIS WEEK?' ❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. El NO _ "represents Je.Aleo eny work relahxAdjuIiea were reported to Selectemp at the hand Injury See reverse for W 1M1er rdonneaon., Wednesday .'r:o t) Signature of of Empl�� Thursday 3 1J ! CLIENT ' We- bunize' that to transfer one of Selech mp's employees to our 'J J F' payroll requires a settlement. .See : rewrsefor further Information. I • Friday i l .�: :hereby car that the above hours era mi 'Saturday " ' X ''� r• - - Signal ra of Supervisor TOTAL TOTAL Hours to nearest quarter. hour. HC?.j - Title Date CUSTOMER, COPY CUSTOMER, COPY