Republic of the Philippines Republic of the Philippines

Province of Aurora Province of Aurora

Municipality of San Luis Municipality of San Luis
Barangay 04 Poblacion Barangay 04 Poblacion
-oOo- -oOo-
_________________________________ _________________________________

Cash for Work Cash for Work

DAILY TIME RECORD DAILY TIME RECORD

NAME: _____________________________________ NAME: ____________________________________

For the Month of: ____________________________ For the Month of: ___________________________
Regular Days: _______________________________ Regular Days: ______________________________
Saturdays/Sundays: __________________________ Saturdays/Sundays: _________________________

A.M. P.M. A.M. P.M.

DATE DATE
IN OUT IN OUT IN OUT IN OUT

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 hours of work performed, record of correct report of hours of work performed, record of
which was made daily at the time of arrival and which was made daily at the time of arrival and
departure from office. departure from office.

_______________________________ _______________________________
CFW BENEFICIARY CFW BENEFICIARY

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

KGWD. NILO T. PANDO KGWD. NILO T. PANDO

Timekeeper Timekeeper

HIPOLITO B. GARCIA, JR. HIPOLITO B. GARCIA, JR.

Punong Barangay Punong Barangay