EMPLOYEE TIMESHEET For:

Leonard

Santa Cruz Supported Living

PO Box 3996, Santa Cruz, CA 95063 Barb Stymiest - 359-9101 Joe Shimpfky - 332-6529 Activity In Out Client Activity Total

Pay periods are from 1st to 15th and 16th to end of month (please circle) Timesheets due by 5pm on the 14thth and 29th or 30th of each month Date In Out Client Activity In Out Client 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
9am 3pm 9pm 12am 12am 9am at at 12pm 10pm ts 3pm 9pm ts

3 19

Total Hours
(electronic signature)

34

Leonard M Ross

10/15/13 DATE

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