New Search
7 ­ l SELE(TEMP <br />EMDL0YMENT'SERVI(ES <br />P.O. Box 71250 Eugene, OR_ 97401 " <br />I . <br />"DI FACE PRINT <br />Sunday <br />Monday <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 />1 <br />(Qf <br />3D <br />a- <br />CQ ZD 30 9 <br />EMPLOY E <br />O�VI V1 G� Psl \,-e, <br />CIAL SECURITY NUMBE <br />C � o rPAN A h-P <br />JOBSITE NAME RAND /OR O# <br />W EK ENDING DATE <br />1� /� <br />❑ AS COMPLETED 'krRETURNING NEXT WEEK <br />HAVE YOU HAD AN ON THEaUOB INJURY THIS WEEK? <br />❑ YES IF YES NOTIFY SELECTEMP IMMEDIATELY. <br />,ONO i <br />V I <br />Hours to nearest quarter hour. " <br />9616 . <br />CUSTOMER COPY <br />FOR OFFICE USE ONLY <br />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 / t�IJnju ry. See reverse for furtheypformati n. <br />Signature of Employee <br />CLIENT <br />We realize that to transfer one of Selectemp's employees to our <br />payroll regqt.yEesa - men. verse for further information. I <br />heretSTCslifJL that,the above hours ar correct. <br />