WP E-Signature by Approve Me - Sign Documents Using WordPress -

Timeclock Adjustment Request

Name:

Email:

Please Adjust My:

Adjust my Start Time For This Date:

To this Adjusted Time:

Adjust My Lunch Start For This Date:

To This Adjusted Time:

Adjust My Lunch Stop For This Date:

To This Adjusted Time:

Adjust My End Time of Day:

To This Adjusted Time:

Reason For This Request:

Additional Notes:

By signing this form I am certifying that I would like my time adjusted in the value(s) above. The time adjustment above is to my knowledge true and correct.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

August 8, 2022 5:26 pm CDT

Timeclock Adjustment Request Uploaded by Randy Bacik - randy@glasscasa.com IP 192.168.0.1

August 8, 2022 9:34 pm CDT

TimeClock Admins - timeclock@glasscasa.com added by Randy Bacik - randy@glasscasa.com as a CC'd Recipient Ip: 104.28.32.197

August 8, 2022 9:42 pm CDT

TimeClock Admins - timeclock@glasscasa.com added by Randy Bacik - randy@glasscasa.com as a CC'd Recipient Ip: 104.28.32.197

May 1, 2023 11:35 am CDT

TimeClock Admins - timeclock@glasscasa.com added by Randy Bacik - randy@glasscasa.com as a CC'd Recipient Ip: 192.168.0.1