General Form No.

7(A)
Revised August, 1948 TIME BOOK AND PAYROLL

(State job or project on which labor was performed)

TIME ROLL
(Market time each day under proper date using
WAGES DEDUCTIONS SIGNATURE OR
RESIDENCE CERTIFICATE
NO. Occupation fraction when necessary) NO. OF THUMB MARK Place of
NAME DAYS
RATE TOTAL Term Total Net
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 PER Medicare NUMBER DATE Issue
WORKE
D
DAY AMOUNT Insurance Deductions Amount
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL - - 0.00
1. I HEREBY CERTIFY that each person whose name appears on 2. I CERTIFY that this roll is correct, every person whose name 3. I CERTIFY on ,my official oath that I have this_________day
this roll rendered service as indicated and for the time stated. appears hereon rendered service for the time and at the rates stated, of __________, ____paid in cash to each man whose name appear
under my general supervision, and I approve payments of this roll. on the bove roll, the amount set opposite his name, he having
presented himself, established his identify, and fixed his signature\
or thumb mark on the space provided therefore. Unpaid services
are indicated by red ink through the column "Amount Paid"

Chairman, Finance and Appropriation Superinted or Foreman In-Charge Special Disbursing Officer, Paymaster
Principal Barangay Chairman

NOTE: - Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof with
proper indication of the corresponding laborer's number and on the corresponding line on the payroll a remark "see thumb mark on the back" should be written.
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