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University of Illinois at Chicago GA/RA/TA Time Report -- CUPPA Pay Number: Pay Dates: / / to / / Student's Name Unit Federal Work Study Conversion Chart for minutes to tenths of hours. 1-2 min. = .0 3-9 min. = .1 9-14 min. = .2 15-20 min. = .3 21-26 min. = .4 27-32 min. = .5 33-38 min. = .6 39-44 min. = .7 45-50 min. = .8 UIN Regular Grad. Appointment 51-56 min. = .9 57-60 min. = 1.0 DATE M T W TH F IN OUT IN OUT TOTAL WEEK 1 TOTAL DATE M T W TH F IN OUT IN OUT TOTAL WEEK 2 TOTAL Student's Signature Date I hereby certify that this time card is a true statement of the hours worked by this student and that the work assigned has been performed in a satisfactory/unsatisfactory* (circle one) manner. Unit rev 02/16/06 Approval Date

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