Missed Punch Report

I,    ______________________________________________

                  (print your name here, and print clearly)

Did not Clock In or Out on the time clock as promised.

The proper time was:  _______________ 

 The proper date was:   _______/_____/______.

 Witnessed:  ________________________________________

                                   (supervisors signature goes here)

 Note:  We hold these for 90 days, after that, this is discarded.

A copy of this will be saved in your employee file  for wage and hour records.

Original to file.

CC to employee.