Time Adjustment Form Request for change to paid time punch activity. First & Last name(Required)Department(Required)Select DepartmentKayak PittsburghYouthWork location of time clock error(Required)Where were you working during the missed punch/time system malfunction?Date of work(Required) MM slash DD slash YYYY Time work started(Required) Hours : Minutes AM PM AM/PM Break time start Hours : Minutes AM PM AM/PM Break time end Hours : Minutes AM PM AM/PM Time work ended(Required) Hours : Minutes AM PM AM/PM Supervisor in charge(Required)The name of your supervisor in charge of the work being done at the time of the time clock errorError descriptionPlease describe the issue (i.e. missed punch, unable to login, system error, etc.) to help us better troubleshoot for the future.Signature(Required)Date MM slash DD slash YYYY Date MM slash DD slash YYYY
