Apply for v Time Sheet Adjustment -Internal Use Only

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:v Time Sheet Adjustment -Internal Use Only
ID:1021
Department:Human Resources
Contact Information
* First Name:
* Middle Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Albert USA -Time Sheet Adjustment
To be completed when an employee misses punches on the time clock and needs to have a manual adjustment made to their time sheet. If you need adjustments made for more than one day, please complete one form for each day.
* Date that time sheet needs adjusted:
* Punch to correct:
In at beginning of shift   Out for lunch   Back from lunch   Out at end of shift   Out for leaving other than breaks.   Back from leaving other than breaks.
* Correct Time:
* AM or PM
AM   PM
Punch to correct:
In at beginning of shift   Out for lunch   Back from lunch   Out at end of shift   Out for leaving other than breaks.   Back from leaving other than breaks.
Correct Time:
AM or PM
AM   PM
Punch to correct:
In at beginning of shift   Out for lunch   Back from lunch   Out at end of shift   Out for leaving other than breaks.   Back from leaving other than breaks.
Correct Time:
AM or PM
AM   PM
To correct:
In at beginning of shift   Out for lunch   Back from lunch   Out at end of shift   Out for leaving other than breaks.   Back from leaving other than breaks.
Correct Time:
AM or PM
AM   PM
Note to HR if needed:  (No personal or medical information):

___________________________________________________________________________________________________________________________________

• By signing below, I am stating I have entered correct information for my time sheet.  I am aware that  willfully entering false information for payroll purposes is considered a Class III policy violation.

• Please type your First and Last name as an electronic signature to acknowledge that this request is only intended for current employees and you confirm that are the employee and you completed this form by yourself.

*

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