DAILY RECORD OF CALLBACK EMPLOYEE   EMPLID

Employee:

     

Emplid #:

     

Day of the Week:

     

Date:

     

Supervisor Authorizing the Call-Back:

     

Time Employee Called-Back:

     

Time Employee Reported:

     

Time Employee Departed:

     

Hours Worked

     

Supervisor Authorizing the Call-Back:

     

Time Employee Called-Back:

     

Time Employee Reported:

     

Time Employee Departed:

     

Hours Worked

     

Supervisor Authorizing the Call-Back:

     

Time Employee Called-Back:

     

Time Employee Reported:

     

Time Employee Departed:

     

Hours Worked

     

Supervisor Authorizing the Call-Back:

     

Time Employee Called-Back:

     

Time Employee Reported:

     

Time Employee Departed:

     

Hours Worked

     

Employee Signature

Date

Supervisor Signature

Date