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Time Sheet and Billing Form WEB 2013


Timertimer
* = required field

District Financial Aid Office
11011 SW 104 Street, Room 1125, Miami, FL 33176
Florida Work Experience Program: (305) 237-0386
Facsimile: (305) 237-2787

Time Sheet and Billing Form



Please fill out this form completely and accurately. MAIL THIS COMPLETED FORM WITH YOUR PAYROLL DOCUMENTATION FOR THE MONTH TO THE ABOVE ADDRESS NO LATER THAN BY THE 15th DAY OF THE NEXT MONTH.

*
* *
* * *

Pay Period:      

Hours Worked by Calendar Day
SUN
MON
TUE
WED
THU
FRI
SAT
Total Hours Worked
Week 1                     

Week 1

  
Week 2                     

Week 2

  
Week 3                     

Week 3

  
Week 4                     

Week 4

  
Week 5                     

Week 5

  

Total Hrs. Worked:

*

Hourly Rate of Pay:

*

Gross Compensation:

*
I hereby certify that this Time Sheet is a true statement of the time worked by me and that I have been paid by the employer for the amount shown.



Student's Signature:  ___________________________________________       Date:  _____________________

I hereby certify that this Time Sheet is a true statement of the time worked by this student, that the work assigned was completed satisfactorily and that the student has been paid the amount of net earnings as shown.



Employer's Name:  ___________________________________  



Employer's Signature:__________________________________     Date:  _____________________



Received By:  ________________________________________     Date:  _____________________