CHARLOTTE-MECKLENBURG SCHOOLS
Form 4233.5
NON-EXEMPT EMPLOYEE WEEKLY TIME REPORT
WEEK BEGINNING EMPLOYEE
LOCATION SSN
Absent
Absence
HOURS WORKED: Indicate Actual Time (white) and Converted Time from Conversion Chart Below (Gray)* Time Code
IN OUT IN OUT IN OUT IN OUT TOTAL
Monday
Monday
Tuesday
Tuesday
Wednesday
Wednesday
Thursday
Thursday
Friday
Friday
Saturday
Saturday
Sunday
Sunday TOTAL
TOTAL HOURS WORKED
8:05 12:00 12:30 16:32 Non-Overtime Hours Worked
EXAMPLE 8.0
8.0 12.0 12.5 16.5 0.0 0.0 0.0 0.0 Comp. Time Hours Worked
Overtime Pay Hours Worked
*Note: Per Board Policy GCBC, holidays designated in the school calendar shall be considered time worked. Total Hours Worked
Approved Leave Hours
CMS ABSENCE CODES
#1 Sick Leave #5 Other Absence–With Deduction #20 Annual Leave
#2 Shared Leave #6 Personal Leave-With Deduction #22 Annual Leave-Catastrophic Illness
#3 Extended Sick Leave #7 Absence Without Pay #28 Bonus Leave CONVERSION CHART
#4 Other Absence – No Deduction #10 Child Involvement #99 Comp. Time Used** 0-5 minutes = .0 30-35 minutes = .5
** code used when taking accrued cmp. Time off from work. Comp. Time accrued when working overtime should be 6-11 minutes = .1 36-41 minutes = .6
indicated under the Comp. Time Hours column as part of Total Hours Worked. 12-17 minutes = .2 42-47 minutes = .7
18-23 minutes = .3 48-53 minutes = .8
24-29 minutes = .4 54-59 minutes = .9
INSTRUCTIONS:
1. Record actual time in and out in white Hours Worked Blocks (e.g.,8:07 am, 3:30 p.m.).
2. Convert and round time to nearest 1/10th of an hour using chart and record in gray
hours Worked blocks(e.g., 8:07 a.m. = 8.1; 3:30 p.m. = 15.5).
3. On or before Monday of each week, sign and deliver the Weekly Time Report of the
previous week to your supervisor no later than the start of your shift or 8:00a.m., I certify that this time report correctly reflects all time worked by me on behalf of
whichever is earlier CMS for the pay period indicated, including time worked before and after normal
work hours and any overtime worked by me.
EMPLOYEE'S SIGNATURE
DATE
SUPERVISOR'S SIGNATURE