TIMEKEEPING FORM

ER-PA-rev02

TIMEKEEPING FORM
ER-PA-rev02

NATURE

X Official Business (OB) Change Rest Day (RD) Undertime (UT) Vacation Leave with pay
Overtime (OT) Offset Paternity Leave Vacation Leave with out pay
Chage Shift Holiday Overtime (OT) Maternity Leave Sick Leave with pay

Sick Leave with out pay

DATE AND TIME

REASON/JUSTIFICATION/PURPOSE TOTAL # OF DAYS/TIME
FROM TO

I fully understand that I am expected to report for work after the end date/time I indicated herein. Date of leave or time of undertime other than what is approved
shall be considered UNAUTHORIZED. In the event that I am unable to return to CONVERGE or any of its affiliate and be unavailable for work on the indicated date,
for reason beyond my control, I will notify CONVERGE or any of its affiliate by telephone, cellular phone, e-mail, or letter at my expense. My contact address and
contact number while on leave is:

_______________________________________________________________________________________________

Further, I certify that the reason of leave/ undertime indicated herein is true and correct to the best of my knowledge.

Employee Signature Date

Recommended for approval by: Approved by:

Name: Signature: Signature:

Position: Date: 9/2/2017

Remarks: Remarks:

TO BE FILLED OUT BY HRD

Remaining SL before this leave Remaining SL before this leave Noted and Verified by Pay__________________________
Remaining SL after this leave Remaining SL before this leave Signature Over Printed Name
 TIMEKEEPING FORM
ER-PA-rev02

TIMEKEEPING FORM
ER-PA-rev02
SURNAME GIVEN NAME SUBSIDIARY: POSITION: DATE APPLIED:

NATURE TO BE FILLED UP BY HRD

SL VL
Official Business (OB) Offset Sick Leave w/ Pay Balance before this leave

Overtime (OT) Holiday Overtime (OT) Sick Leave w/o Pay Balance after this leave

Chage Shift Undertime (UT) Vacation Leave w/Pay

Change Rest Day (RD) Paternity Leave Vacation Leave w/o Pay Noted and Verified by:

Payroll

DATE AND TIME

REASON/JUSTIFICATION/PURPOSE TOTAL # OF DAYS/TIME
FROM TO

I fully understand that I am expected to report for work after the end date/time I indicated herein. Date of leave or time of undertime other than what is approved
shall be considered UNAUTHORIZED. In the event that I am unable to return to CONVERGE or any of its affiliate and be unavailable for work on the indicated date,
for reason beyond my control, I will notify CONVERGE or any of its affiliate by telephone, cellular phone, e-mail, or letter at my expense. My contact address and
contact number while on leave is:

_______________________________________________________________________________________________

Further, I certify that the reason of leave/ undertime indicated herein is true and correct to the best of my knowledge.

Employee Signature Date

Recommended for approval by: Approved by:

Name: Signature: Name: Signature:

Position: Date: Position: Date:

Remarks: Remarks:

ORIGINAL - ACCOUNTING; DUPLICATE - HRD