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TIME REPORT

Employee Name:               BRETT VAN BENSCHOTEN                             Employee No:                  0645             Pay Period Ending:         2/15/2011
                                                                                    Pay Period / Day of the Month
Job Task & Suffix Pay                                1     2      3      4      5      6      7     8      9     10     11     12      13    14   15         Total
                            Description of Job
    Number        Code                              16     17     18    19     20      21    22    23     24     25     26     27      28    29   30    31   Hours
6001-001-39
                   R     Los Robles                 1.            2.                         1.     .5    1.    2.5                               .5          8.5
$45.00
6011-000-39
                   R     Chino Valley                                                                                                       4.5               4.5
$75.00
6012-000-39
                   R     Pacific Alliance                                                    1.     2.    2.     .5                                           5.5
$65.00
6013-000-39
                   R     Tri-City                                                                                                                              .
$65.00
6014-000-39
                   R     Montclair Hospital                                                               .5                                                  .5
$75.00
6015-000-39
                   R     Mem / Gardena                                                                                                                         .
$70.00
6018-000-39
                   R     Motion Pictures                                                                                                                       .
$75.00
6022-000-39
                   R     Hollywood Presb.                         4.                                             4.                                           8.
$45.00
6024-000-39
                   R     Coast Plaza                                                                                                                           .
$75.00
6025-000-39
                   R     Greater El Monte                                                                                                                      .
$75.00
6915-000-39
                   R     Citrus Valley                     5.           5.                                              5.                                    15.
$27.75
                                                                                                                                                               .
0530-000-00        R     Holiday Pay                                                                                                                           .
0202-000-00        R     Paid Time Off                                                                                                                         .
      DAILY TOTALS & GRAND TOTAL HOURS              1.     5.     6.    5.      .      .     2.    2.5    3.5    7.     5.     .       .    4.5   .5    .     42.
          By signing this timesheet, I hereby verify that I have taken all meal and rest breaks required under California State law.

Signature:_____________________________________          Date:________2/15/2011______Approval:___________________________                   Date:__________________

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Lac timesheet 02 15-11

  • 1. TIME REPORT Employee Name: BRETT VAN BENSCHOTEN Employee No: 0645 Pay Period Ending: 2/15/2011 Pay Period / Day of the Month Job Task & Suffix Pay 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total Description of Job Number Code 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Hours 6001-001-39 R Los Robles 1. 2. 1. .5 1. 2.5 .5 8.5 $45.00 6011-000-39 R Chino Valley 4.5 4.5 $75.00 6012-000-39 R Pacific Alliance 1. 2. 2. .5 5.5 $65.00 6013-000-39 R Tri-City . $65.00 6014-000-39 R Montclair Hospital .5 .5 $75.00 6015-000-39 R Mem / Gardena . $70.00 6018-000-39 R Motion Pictures . $75.00 6022-000-39 R Hollywood Presb. 4. 4. 8. $45.00 6024-000-39 R Coast Plaza . $75.00 6025-000-39 R Greater El Monte . $75.00 6915-000-39 R Citrus Valley 5. 5. 5. 15. $27.75 . 0530-000-00 R Holiday Pay . 0202-000-00 R Paid Time Off . DAILY TOTALS & GRAND TOTAL HOURS 1. 5. 6. 5. . . 2. 2.5 3.5 7. 5. . . 4.5 .5 . 42. By signing this timesheet, I hereby verify that I have taken all meal and rest breaks required under California State law. Signature:_____________________________________ Date:________2/15/2011______Approval:___________________________ Date:__________________