New Search
S-ELE(TEMP <br />EMPLOYMENT SERVICES <br />P.O. Box.71250 • Eugene, OR 97401 <br />.DI CACC DDIKIT <br />*nday <br />Monday <br />EMPLOYEE y � ; ME <br />Gum l',alr <br />SOG4AL SECURITY. NUMBER <br />COMPANY NAMt <br />JOBSITE NAME AND /OR PO# <br />WEEK ENDING DATE <br />❑ ASSIGNMENT COMPLETED eRETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? <br />❑ YES IF YES, NOTIFY SELECTEMP IMMEDIATELY. <br />e'NO <br />Tuesday <br />Wednesday <br />Thursday <br />Friday <br />Saturday <br />START <br />STOP.''' <br />'; ' LESS <br />LUNCH <br />REG . <br />HOURS <br />OVERTIME <br />HOURS <br />le: <br />Z: <br />3c <br />U0 <br />Z <br />-a>o <br />S <br />L <br />Z: <br />30 <br />X2:330.6. <br />FOR OFFICE USE ONLY <br />REG. HOURS O.T,HOURS <br />EMPLOYEE <br />I certify that the hours shown represent my total hours worked during the . <br />week, and that they were properly verified by the client or by an authorized <br />representative. Also,.any work related injuries were reported to Selectemp <br />at the time of injury. See reverse for fur er information.. . . <br />Signature of Employee ' <br />CLIENT <br />We realize that to transfer one of Selectemp's employees to our <br />payroll requires a settlement.. See reverse for further information. I <br />] �ere that the a ave are correct. ' <br />�"_ <br />ature f upervis r ^7 �7 <br />TOTAL TOTAL I, � � `4- , <br />Hours to nearest quarter hour.'O <br />. Title Date <br />CUSTOMER.-COPY <br />