EMPLOYEE TIMESHEET For: Leonard

Pay periods are from 1st to 15th and 16th to end of month (please circle)
Timesheets due by 5pm on the 14thth and 29th or 30th of each month

Date
In
1 16

Out

Client

Activity

In
3pm

Out
9pm

Client
At

Santa Cruz Supported Living

PO Box 3996, Santa Cruz, CA 95063
Barb Stymiest - 359-9101 Joe Shimpfky - 332-6529

Activity

In
9pm

Out
12am

Client

Activity

At

Total

17

9am

3pm

at

18

12am

9am

at

19

20

9am

3pm

At

21

9am

3pm

Ts

22

23

9am

3pm

Atlantic

24

10

25

11

26

6:30am

4pm

At

9.5

12

27

9am

3pm

13

28

14

29

5:30

15

30

15

Scheduling

.5

31
58
Total Hours

(electronic signature)
Leonard M Ross

00/00/00
DATE

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MANAGER SIGNATURE
DATE