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Personal Information

Name: *
Week Ending: *
How do you want to receive your check: *

By Mail
Pickup

Monday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Monday: *
Time and a Half Hours Woked on Monday: *
Double Time Hours Worked on Monday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Tuesday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Tuesday: *
Time and a Half Hours Woked on Tuesday: *
Double Time Hours Worked on Tuesday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Wednesday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Wednesday: *
Time and a Half Hours Woked on Wednesday: *
Double Time Hours Worked on Wednesday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Thursday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Thursday: *
Time and a Half Hours Woked on Thursday: *
Double Time Hours Worked on Thursday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Friday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Friday: *
Time and a Half Hours Woked on Friday: *
Double Time Hours Worked on Friday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Saturday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Saturday: *
Time and a Half Hours Woked on Saturday: *
Double Time Hours Worked on Saturday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Sunday

Date: *


Select one of the options below *:

Operator:
Oiler:
Truck Driver:
Shop:

Regular Hours Worked on Sunday: *
Time and a Half Hours Woked on Sunday: *
Double Time Hours Worked on Sunday: *
Local #:
Miscellaneous:
Contractor: *
Location: *
Equipment #: *
Total Weekly Hours Worked

The numbers below reflect the total weekly hours worked for each category:


Total Weekly Regular Hours: *
Total Weekly Time and a Half Hours: *
Total Weekly Double Time Hours: *
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