Weekly time record Staples Operartion Support 12 Main St Employee: John Test [Address 2] Manager: TBD "[City, ST ZIP Code]" "Concord, MA 01742" Employee phone: 508-235-0000 Employee e-mail: Week ending: 6/5/2005 Day Regular Hours Overtime Sick Vacation Total Monday 5/30/2005 8.00 2.00 10.00 Tuesday 5/31/2005 8.00 8.00 Wednesday 6/1/2005 8.00 8.00 Thursday 6/2/2005 8.00 8.00 Friday 6/3/2005 8.00 8.00 Saturday 6/4/2005 8.00 8.00 Sunday 6/5/2005 8.00 8.00 Total hours 40.00 2.00 16.00 58.00 Rate per hour 10.00 Total pay $400.00 $400.00 Employee signature Date Manager signature Date