Missed Punch Report

I:    ______________________________________________

                  (print your name here, and print clearly)

Did not Clock In or Out

                   on the time clock as promised.

The proper time was:  _______________ AM   PM  (circle one)

The proper date was:   _______/_____/______.

Witnessed:  ________________________________________

                                   (supervisors signature goes here)

A copy of this will be saved in your employee file

for wage and hour records.

Original to file.

CC to employee.

Provided by www.employeetimeclocks.com

Div:  Florida Time Clock, Inc., Est: 1991

(800) 682 3389