TIME BOOK AND PAYROLL

Payroll for __________________________________for the month of _________________________________ at ________________________________________.

TIME ROLL (Mark time each day under proper date using
fraction when necessary) RESIDENCE CERTIFICATE
OCCUPATION / Total Regular Total
NAME BARANGAY
TOTAL DAYS OF
WORK Rate
Wage
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Amount
Net.Pay No. SIGNATURE OF PAYEE
NUMBER DATE Place of Issue
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

- - -
1 1

- - -
2 2

- - -
3 3

- - -
4 4

- - -
5 5

- - -
6 6

- - -
7 7

- - -
8 8

- - -
9 9

- - -
10 10

-
11 11

-
12 12

-
13 13

-
14 14

-
15 15

-
16 16

-
17 17

-
18 18

-
19 19

-
20 20

Total Amount In Words: - -

1. I HEREBY CERTIFY that each person whose name
appears on this roll rendered serivce as indicated and
for the time stated.
2. I CERTIFY that this roll is correct, every person whose name
appears hereon rendered service for the time and at the rates stated,
under my general supervision, and I approve payment of this roll.
3. I CERTIFY on my official oath I have this ____ day of _______________, ______ paid in
cash to each man whose name appears on the above roll, the amount set opposite his/her
name, he/she having presented himself, established his identity, and affixed his signature or
thumb mark on the space provided therefore. Unpaid services are indiacted by red ink
through the column "Amount Paid".

Timekeeper Special Disbursing Officer, Paymaster or Municipal Treasurer