Time Sheet / Invoice



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Time Sheet / Invoice

Name:       SS#: XXX-XX-     

Program:       Supervisor:      

|Date |Services Provided |Time In |Lunch |Time Out |Hours |

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Total Regular Hours: _________ Total Overtime Hours: _________

Regular Rate of Pay: _________ Overtime Rate of Pay: _________

Total: _________ Total: _________

Total Amount of Pay: _________

__________________________________ __________________________________

Service Provider Signature Date Supervisor Signature Date

***********************************************************************************

Submit to Supervisor for Approval rev. 8/2011 jab final

For 15th payroll by 25th of Previous Month)

For 30th payroll by 10th of Current Month

-----------------------

***For Office/Billing Use***

Account #_____________________________________

Account #_____________________________________

Pay Cycle_______________Date__________________

Posted________________________________________

***Billing Information (If Applicable)***

Student Name/Dist_________________________________________

Student Name/Dist_________________________________________

Student Name/Dist_________________________________________

Student Name/Dist_________________________________________

Student Name/Dist_________________________________________

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