* = Required Information
Weekly Timesheet Form
Ronara Staffing Solutions
3701 Pegasus Dr., Suite 100
Bakersfield, CA 93308
Office:
855-379-3477
Fax:
661-505-7045
email: timekeeping@ronarastaffing.com
Facility
*
Pay Period Dates
*
through
*
Employee Name
*
Last 4 Digits of SSN
Sunday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Monday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Tuesday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Wednesday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Thursday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Friday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Saturday
Date
Unit
Time-In
Time-Out
Lunch
Total Hours
On‐Call Hours
Start Time
End Time
Total
Call-Back Hours
Time In
Time Out
Total
Remarks
Examples include: Cancelled Shift, Orientation, Modules, etc.
Initials of Supervisor
Approval of shifts worked, cancelled shift, missed time & OT must be initialed in appropriate box by supervisor
Total
Total Hours
*
Total Hours (On-Call)
*
Total Hours (Call-Back)
*
Employee Signature
By signing below, I acknowledge that: (1) I have reviewed my hours worked and rate(s) of pay for this pay period and believe them to be accurate as stated on my wage statement; (2) if any punches were adjusted during this pa y period, they were authorized by me; (3) I have been provided the appropriate opportunity for all legally required meal and rest periods in accordance with Company policy; (4) I have not worked off ‐ the ‐ clock; and (5) I agree that my paycheck accurately reflects all compensation due and owing to me fo r the pay period and (6) if I believe an error exists on my paycheck, I must notify my Payroll Department immediately in writing to have the issue resolved (and that in the interim I may keep the paycheck currently provide d while the Company investigates the potential issue)
Employee Signature
*
Date
*
Facility Approval
By signing below, client/facility acknowledges all hours are true and correct.
Authorized Facility Printed Name
*
Authorized Facility Signature
*
Date
*
NOTE: RONARA CANNOT PROCESS TIMESHEETS WITHOUT AUTHORIZED FACILITY SIGNATURE
USE FRACTIONS OF HOURS:
15 minutes = .25 hours
30 minutes = .50 hours
45 minutes = .75 hours
Please fax or email your weekly timesheet to RSS Payroll Department no later than 12:00 (Noon) PST on Tuesday of the Pay Week
Fax: 661-505-7045 or email: timekeeping@ronarastaffing .com
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