Control # _______ RTU-VPFA-HRDC-F-012 Control # _______

I certify on my honor that the above is a true and correct report of

the hours of work performed, record of which was made daily at
Civil Service Form No. 48 the time of arrival and departure from office.

DAILY TIME RECORD

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VERIFIED as to the prescribed office hours:

(Name)

For the month of

Official hours for Regular days
In Charge
arrival and departure Saturdays
Civil Service Form No. 48

DAILY TIME RECORD

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A.M. P.M. Undertime Day A.M. P.M. Undertime

Day
Arrival Departure Arrival Departur Hours Minutes Arrival Departur Arrival Departur Hours Minutes
e e e
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
Total Total
 (Name)

For the month of

Official hours for Regular days
arrival and departure Saturdays

VERIFIED as to the prescribed office hours:

I certify on my honor that the above is a true and correct report of

the hours of work performed, record of which was made daily at the
time of arrival and departure from office. In Charge