DAILY TIME RECORD DAILY TIME RECORD

Name: Name:
Barangay: Barangay:
Period from: To: Period from: To:

AM PM Undertime AM PM Undertime
Day Arrival Depart. Arrival Depart. HR. MIN. Day Arrival Depart. Arrival Depart. HR. MIN.
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
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31

I certify on my honor that the above is a true and I certify on my honor that the above is a true and
correct report of the hours of work performed, record of correct report of the hours of work performed, record of
which was made daily at the time of arrival and departure which was made daily at the time of arrival and departure
from office. from office.

Signature Signature

Checked by: Approved: Checked by: Approved:

VALERIE KRIS F. JAVELOSA VALERIE KRIS F. JAVELOSA

Brgy. Captain Executive Assistant IV Brgy. Captain Executive Assistant IV
Civil Service Form No. 48 Civil Service Form No. 48

DAILY TIME RECORD DAILY TIME RECORD

JUAN A. DELA CRUZ JUAN A. DELA CRUZ

(Name) (Name)

For the month of APRIL 01-15, 2021 For the month of APRIL 16-30, 2021
Official hours for arrival Regular days 8:00 - 12:00 Official hours for arrival Regular days 8:00 - 12:00
and departure 1:00 - 5:00 and departure 1:00 - 5:00

AM PM Undertime AM PM Undertime
Day Arrival Depart. Arrival Depart. HR. MIN. Day Arrival Depart. Arrival Depart. HR. MIN.
1 7:48 12:01 12:59 5:00 1
2 7:47 12:03 12:45 5:00 2
3 7:43 12:00 1:00 5:00 3
4 7:48 12:05 12:56 5:00 4
5 7:43 12:03 12:59 5:00 5
6 SATURDAY 6
7 SUNDAY 7
8 7:59 12:00 12:58 5:00 8
9 7:47 12:03 12:45 5:00 9
10 7:48 12:05 1:00 5:00 10
11 7:55 12:00 12:58 5:00 11
12 7:47 12:03 12:45 5:00 12
13 7:48 12:00 12:58 5:00 13
14 SATURDAY 14
15 SUNDAY 15
16 16 7:48 12:01 12:59 5:00
17 17 7:44 12:03 12:45 5:00
18 18 7:48 12:00 1:00 5:00
19 19 7:48 12:05 12:56 5:00
20 20 7:43 12:03 12:59 5:00
21 21 SATURDAY
22 22 SUNDAY
23 23 7:59 12:00 12:58 5:00
24 24 7:58 12:00 1:00 5:00
25 25 7:48 12:05 1:00 5:00
26 26 7:55 12:00 12:58 5:00
27 27 7:56 12:10 1:00 5:00
28 28 7:42 12:00 12:58 5:00
29 29 SATURDAY
30 30 SUNDAY
31 31

I certify on my honor that the above is a true and I certify on my honor that the above is a true and
correct report of the hours of work performed, record of correct report of the hours of work performed, record of
which was made daily at the time of arrival and departure which was made daily at the time of arrival and departure
from office. from office.

JUAN A. DELA CRUZ JUAN A. DELA CRUZ

VERIFIED as to the prescribed office hours. VERIFIED as to the prescribed office hours.

MARCEL H. IRISARI MARCEL H. IRISARI

PESO Manager PESO Manager
Instructions: Please edit the texts in Red and Blacken it
afterwards.

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With initial signature of Immediate Supervisor
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