Timecard Adjustment Request

Timecard Adjustment Request
Name

First NameLast Name
Facility Name
Date of Shift

MonthDayYear
2 digit month, 2 digit day, 4 digit yearShift Date
Type of Request
Reminder! Late cancelation requests will only be valid if submitted within two weeks of the shift date.
Meal breaks are mandatory and are always included on the timecard. Only if absolutely necessary, and with the approval of the facility supervisor, can you work through your lunch break. Please attach your SIGNED and authorized missed meal form in order for us to process this adjustment.
Time of Scheduled Shift

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Time of Arrival and Departure

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Exact time of cancellation

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
How were you informed of the cancellation?
What was the reason given for the cancellation?
Name and title of supervisor who canceled the shift

First NameLast Name
Did you punch on Eshyft app
Why didn't you punch in on the Eshyft app?
Attach Verification of cancelation from the facility (Ex Email, Text or Signed document from the facility)

Cancelof
time adjustment type
What was the reason for the incorrect clock in ?
What was the reason for the incorrect clock out?
What was the reason for not clocking in or out?
Correct rate /hr
What was the reason for not taking a meal break?
Name of supervisor who requested you come in early or stay late?
Late cancelation request
Please upload any documentation you may have.

Documentation can be any of the following:
1. A picture of a signed MPF from the facility (If you need a MPF, you can print one using this link.)
2. A screenshot of an email from the facility manager (with their email address visible)
3. A piece of paper approving this request with the date, time, and signature of the facility manager.
If you do not have any documentation, you can skip this step and we will confirm the details with the facility (this may cause a delay in processing your request)
Cancelof
Cancelof
Cancelof
Cancelof
Please enter the full name and title of the supervisor who provided this validation.

First NameLast Name
Title
Comments
Should be Empty: