Employee certifies that regular, leave taken, and premium hrs. worked is accurate, and is in keeping with Department
regulations.
Supervisor Action and Certification
Time Keeper Certification
Date (mm-dd-yyyy)
Date (mm-dd-yyyy)
Date (mm-dd-yyyy)
Pay Period
Employee Comments
AL SL CU ND SDLWRD OtherCW
Name
Last First Middle
HPDate Start Time End Time OT
Saturday
Day
Period Totals:
TIME AND ATTENDANCE 2021
U.S. Department of State
DS-4151
12-2020
TW
Supervisor Action
Supervisor Comments
Thursday
Tuesday
Monday
Thursday
Wednesday
Monday
Friday
Sunday
Friday
Wednesday
Tuesday
Saturday
Sunday
Employee Signature
Time Keeper Signature
Supervisor Signature
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00