EmailMe Form - Time Edit Request Form - TERF

Time Edit Request Form - TERF

*Please note that the submission of TERFs is not an acceptable form of time worked submission, and should only be used in very rare instances. Difficulty logging in must be addressed with the payroll department by emailing bbrummer@zumbrohouse.com

*The form must be filled out completely, in order to be processed.

*Complete this form whenever you were unable to clock in or clock out of ADP, for any time worked - must be submitted within 24 hours of the shift worked.

*Due to the high volume of TERFs that require camera confirmation, there may be a one pay period delay in payment.

*THE MAIN OFFICE CONFIRMS THE ACCURACY OF ALL TERFS SUBMITTED, VIA CAMERA CHECKS. FALSIFIED OR INACCURATE REPORTING OF TIME WORKED, WILL RESULT IN DISCIPLINARY ACTION, UP TO AND INCLUDING TERMINATION.

Name *
First Last
Phone *
### - ### - ####
Email *
Clock In Department/Site/Location Worked *
(This is the location you were at for the start of your shift)
Clock Out Department/Site/Location Worked *
(This is the location you were at for the end of your shift)
If you worked at multiple locations please list them all here:
Date you clocked in *
MM / DD / YYYY
Date you clocked out *
MM / DD / YYYY
Scheduled Shift *
Actual time you started working (required) *
HH : MM AM/PM
Actual time you stopped working (required) *
HH : MM AM/PM
Lunch Start
HH : MM AM/PM
This is the start time of your 30 minute unpaid break
Lunch End
HH : MM AM/PM
This is the end time of your 30 minute unpaid break
If you arrived early or stayed late, please tell us why?
Reason For Deviation *
Missed Clock-In
Missed Clock-Out
Please describe the reason for the TERF submission, in detail. In order for us to help resolve the problem, we must know exactly what the issue was. *
Did you notify the supervisor if there was a computer or internet related issue?
Yes
No
Signature - Use your mouse to sign. *
Clear
By checking this box you verify that before you click submit you have double checked all locations, dates and times to verify that they are correct and understand if they are not this TERF may be considered false. *
All fields are correct