2011-2012 SelectTemp Invoices - Laserfiche WebLink

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T't ' 1 1 0unday , EMPLOYMENT SERVICES P.O. Box 71250 • Eugene, OR 97401 M Monday DI..I= ACF EMPLOYEE 7, M S SOCIAL SECURITY NUMBER COMPANY NAME C Af G'1 ge JOBSITE NAME ND /OR PO# EEK NDING DATE ASSIGNMENT COMPLETED / KETURNING NEXT WEEK HAVE YOU HAD AN ON THE JOB INJURY THIS WEEK? ❑ YES. IF YES, NOTIFY SELECTEMP IMMEDIATELY. NO , Tuesday Wednesday Thursday Friday Saturday START STOP LESS REG OVERTIME LUNCH HOURS HOURS .,?o 3P 1 �. Z= 30 '/L o FOR OFFICE USE ONLY �. HOURS O.T. HOURS EMPLOYEE - I certify that the hours shown represent my total hours worked during the. week, and that they were properly verified by the client dr by.an authorized representative. Also, any work related injuries were reported to Selectemp - at the time of inj ee reverse for further information. X Signature of Em a .. CLIENT We realize that to transfer one of Selectemp's employees to our payroll requi s,a settlement..See reverse for further information. I hereby c t' that the above hours are correct. Signature of Supp �isorr . . / 7O / TAL TOTAL Hours to nearest quarter hour. LI v V / 4//� Title � Date CUSTOMS OPY FOR OFFICE USE ONLY �. HOURS O.T. HOURS EMPLOYEE - I certify that the hours shown represent my total hours worked during the. week, and that they were properly verified by the client dr by.an authorized representative. Also, any work related injuries were reported to Selectemp - at the time of inj ee reverse for further information. X Signature of Em a .. CLIENT We realize that to transfer one of Selectemp's employees to our payroll requi s,a settlement..See reverse for further information. I hereby c t' that the above hours are correct. Signature of Supp �isorr . . / 7O / TAL TOTAL Hours to nearest quarter hour. LI v V / 4//� Title � Date CUSTOMS OPY