Author: Sullivan, Beverly - Payroll & Benefits

MONTH: ______________________, 20_______
Name: _____________________Bus #______
*If you have a sub, please write substitute’s name on the sub line
*If you are a substitute, write the name ae of the driver/monitor you are subbing for. *FT=field trips, put hours for trip
Driver Monitor Driving Training Riding

CODES:
S = Sick Day
P = Personal Day
LWOP = Leave Without Pay

PAYROLL USE ONLY:
Total Regular Hours: _________________
Hourly Rate: _____________________
Payroll Code:______________________________________
Total Leave without Pay Hours: _______________

Mon	Tue	Wed	Thu	Fri	Sat	Sun	Total Hours
_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	FT ______	FT ______
_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	FT ______	FT ______
_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	FT ______	FT ______
_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	FT ______	FT ______
_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	_____am ______pm / Sub: ____________ / FT____________	FT ______	FT ______

Employee’s Signature: _________________________________________ Supervisor’s Signature: _______________________________________

DAYS WORKED