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(Company No. 101067-P)

EXTRA WORKING HOURS CLAIM FORM

Month:Year:

Name: Salary Grade:Basic Salary:

Staff No.:Position: Department:

Particular

Time

Normal

Day

Saturday/Sunday

Public Holiday

From

To

Normal

Hours

Overtime

Normal

Hours

Overtime

TOTAL

During normal working hoursOutside normal working hours

Working on Saturday/Sunday

4 hrs ::timesExtra Working Hours on normal day:hrs

4 hrs but 8 hrs :timesExtra Working Hours on Saturday/Sunday:hrs

Working on Public Holiday:timesExtra Working Hours on Public Holiday:hrs

I hereby declare the above claim is true.I hereby approve the above claim.

___________________________________________________

Signature of ApplicantSignature & Official stamp

Dean/Head of Department

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