Time Clock Correction Form

Time Clock Correction Form
Employees: If you failed to clock in/out or your time needs a correction, please complete this form before the payroll period ends. Use a separate form for each date. Enter the ACTUAL time you arrived or left, NOT your scheduled time.
Time Clock Information
Name
First NameLast Name
Date of Shift
MonthDayYear
Date
Clock In Time
Hour Minutes
AM/PM Option
Clock Out Time
Hour Minutes
AM/PM Option
Break Clock Out Time
Hour Minutes
AM/PM Option
Break Clock In Time
Hour Minutes
AM/PM Option
Reason for Correction
Employee Approval: I certify that the information reported above reflects the accurate correction needed for Payroll.
Signature
Clear
Should be Empty: