WEEK ENDING SUNDAY
EMPLOYEE NAME (PRINT)
EMPLOYEE SIGNATURE
EMPLOYEE NUMBER
CLIENT NAME
ADDRESS
DAY DATE START FINISH LUNCH TOTAL REG TOTAL OT
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
AUTHORIZED SIGNATURE
TITLE
Print Hours
REG HRS
REG MIN
OT HRS
OT MIN
CLIENT NAME (PRINT)
IS THIS EMPLOYEE    YES
CONTINUING THIS    NO 
ASSIGNMENT?                  		TOTAL HOURS TO THE
NEAREST QUARTER HOUR
TOTAL HOURS
* EMPLOYEE: I CERTIFY THAT THE HOURS SHOWN HEREON REPRESENT THE TOTAL HOURS WORKED THIS WEEK BY ME, AND WERE PROPERLY VERIFIED.
** CLIENT: YOUR SIGNATURE REPRESENTS THAT YOU ARE IN AGREEMENT WITH ALL THE TERMS AND CONDITIONS AS SET FORTH ON THE FRONT HEREOF AND THAT THE HOURS SHOWN ARE CORRECT AND THE WORK WAS COMPLETED IN A SATISFACTORY MANNER.
EMPLOYEE INFORMATION
All work performed in excess of 40 hours per week (Mon-Sun) will be at straight time, unless otherwise stated by the client. Overtime (at time and 1/2) is permitted ONLY if requested and approved by the client. Approval MUST FIRST be obtained from us by the client. IF YOU DO NOT CONTACT US after each assignment, we will assume you are not available for work.
CLIENT INFORMATION
Should your firm or any of its affiliates of clients hire the consultant named on this time card on a full-time or consultant basis at anytime during contracting period or within one year of end-date of contract, your firm agrees to pay our placement service charge as follows:
         30% of the hourly rate multiplied by 2080. For example: hourly rate $10 X Factor 2080 = $20,800.00 X 30% = $6,240,00 Conversion Fee