Extra Duty Time Sheet Payroll Request

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EXTRA DUTY TIMESHEET/PAYROLL REQUEST
Name:
SSN: XXX-XX-___ ___ ___ ___
(Last four numbers only)
Campus: _____________________________________________
 Professional
 Paraprofessional
(Attach comp-time balance spreadsheet)
Program Title:
(Description of work performed)
Budgetary Code
:
(THIS LINE MUST BE COMPLETED)
Date
Start Time
End Time Total Hours
Total hours
0.00
for the week:
Pay Rate
x
: ___________
$ 0.00
Gross Amount: __________
=
Employee Signature: ____________________________
Date: __________________
Campus Approval: ______________________________
Date: __________________
Central Office Approval: __________________________
Date: __________________
Timesheets must be completed on a weekly basis and turned in to your campus or department for
approval. See the Monthly Pay Schedule for cut-off dates on our district’s website.
P/R:6/12/14 rev.

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