Employee Time Clock Cutoff Request Form
Submit your request for a time clock cutoff adjustment. Please complete all fields accurately to ensure prompt review.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Department
*
Please Select
Human Resources
Finance
Operations
Sales
Customer Support
IT
Other
Work Date for Adjustment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Original Clock-In Time
*
Hour Minutes
AM
PM
AM/PM Option
Original Clock-Out Time
*
Hour Minutes
AM
PM
AM/PM Option
Requested Clock-In Time
*
Hour Minutes
AM
PM
AM/PM Option
Requested Clock-Out Time
*
Hour Minutes
AM
PM
AM/PM Option
Reason for Adjustment
*
Supervisor/Manager Name
*
Submit Request
Should be Empty: