EMPLOYEE TIMESHEET For: Leonard Santa Cruz Supported Living

Pay periods are from 1

st
to 15
th
and 16
th
to end of month (please circle) PO Box 3996, Santa Cruz, CA 95063
Timesheets due by 5pm on the 14th
th
and 29
th
or 30th of each month Barb Stymiest - 359-9101 Joe Shimpfky - 332-6529
Date In Out Client Activity In Out Client Activity In Out Client Activity Total
1 16
2 17
3 18 9am 3pm ts 9pm 12am at 9
4 19 12am 9am At 9am 3pm At 3pm 12am ts 24
5 20 12am 9am Ts 9am 3pm Ts 15
6 21 9am 3pm Ts 9pm 12am Ts 9
7 22 12am 9am Ts 9am 3pm At 15
8 23
9 24
10 25 9pm 12am At 3
11 26 12am 9am At 9am 3pm At 3pm 12am TS 24
12 27 12AM 9AM TS 9AM 3PM TS 15
13 28
14 29 9AM 3PM AT 6
15 30
31


Total Hours 120
(electronic signature) 00/00/00 ____________________________________ ______________
Leonard M Ross DATE MANAGER SIGNATURE DATE