Timesheet Correction Request Form
This must be completed and approved PRIOR to being processed by Payroll (Monday of Payweek). Failure to do so will result in discrepencies in your paycheck. A correction must be requested for each date needed to be corrected.
Employee Name
*
First Name
Last Name
Email
example@example.com
Department
*
(ie: Transportation, Student Services, Maintenance, etc)
School
*
Please Select
Bellows Falls Union High School
Bellows Falls Middle School
Central Elementary School
Saxtons River Elementary School
Westminster Center School
Grafton Elementary School
WNESU
PreK
Please select the builiding of your primary location.
Date to be corrected
*
-
Month
-
Day
Year
Date
Correct Time In Morning
*
Hour Minutes
AM
PM
AM/PM Option
Correct Time Out Lunch
*
Hour Minutes
AM
PM
AM/PM Option
Correct Time In Lunch
*
Hour Minutes
AM
PM
AM/PM Option
Correct Time Out Afternoon
*
Hour Minutes
AM
PM
AM/PM Option
Please correct my timesheet for the reason below:
*
Please Select
I did NOT clock in at the beginning of my workday
I did NOT clock out at the end of my workday
I did NOT clock in or out for lunch
The time clock was not working
I clocked IN at the wrong time
I clocked OUT at the wrong time
Other (Please Specify)
Other Correction Reason (If you chose "Other")
Employee's Signature
*
Date
*
-
Month
-
Day
Year
Date
Supervisor
Please Select
Kate Kane
Laura Hazard
Liz Harty
Angela Cartier
Rick Schuhmann
Jeff Potter
Ricky Adams
Kelly O-Ryan
Henry Bailly
Stan Budzik
Melissa Bacon
Jennifer Keenan
Heather Willis-Doxsee
This form should be used before the timesheet has been processed (no later than the Monday of Payweek) by Payroll.
If this is submitted after processing, your paycheck with reflect the times entered and adjustments will show on your next paycheck.
Submit
Should be Empty: