Professional legal forms

Hcl healthcare timesheet form HCL Healthcare Timesheet PLEASE COMPLETE IN BLOCK CAPITALS AND IN BLACK INK Timesheets should be completed accurately and legibly and then submitted by 12 midnight to be processed on the following

Ucsd student life student time... UCSD Student Life Student Timesheet Employee Last Name: First Name: Employee Has Work Study Employee ID# Department (Check One): A.S. CAPE Grove CSI First Day of Pay Period Month: GSA Day: Lecture

Independence timesheet form GT Independence Self Directed Timesheet Agency Code Member Name Print Service Codes T1019 - Personal Care S5135 - Adult Companion Care S5125 - Attendant Care S5130 - Homemaker Service S9124 - Intermittent Skilled Nursing Fax to GT Independence 855-329-8648 Employee Name Period Begin Period End Date Mo/Day In am/pm Out am/pm Total Hrs This timesheet shows the correct service and the correct number of hours that I have provided care to the participant during this time period. Signature of Direct Service Worker Signature of Participant/Representative Please note that direct service workers are NOT allowed to work more than 40 hours per week.

Biweekly timesheet for persona... www.palcofirst.com Biweekly Time Sheet Make plenty of copies of this timesheet. This is the only timesheet that will be accepted. If you make a mistake, mark a single line through the mistake, initial

Telesearch timesheet form tele... TeleSearch, Inc. P.O. Box 673 Flanders, NJ 07836 (973) 9277870 (973) 9276914 (Payroll) (973) 9277880 (FAX) 1. Please Print All Entries Except Signatures. 2. Round Time to the Nearest Quarter Hour.

Sweet home healthcare timeshee... Employee Signature Date Timesheets are due by 12 p.m. Monday. Please drop off fax to 267-639-9615 or email to timesheets sweethomehealthcare. com. You will NOT be paid without your timesheet. CONDITIONS Consumer agrees to terms of NET UPON RECEIPT and understands that unpaid accounts will be considered in default after thirty 30 days after which a default charge will be imposed at 1 per month on unpaid balances Annual rate of 18. or the legal interest whichever is lower. Client agrees to pay default charge and reasonable attorney s fee for cost of collection. Client recognizes the rights of Sweet Home HealthCare as the employer and agrees to NOT employ the person named herein for a period of 90 days following termination of this assignment unless assessment fee is paid. Fee is 2500. Sweet Home Primary Care LLC TIME SHEET Time Period thru Monday through Sunday PRINT EMPLOYEE NAME PRINT CONSUMER NAME CLASSIFICATION DCW / HHA / CNA DAY Mon Tues Wed Thu Fri Sat Sun DATE START TIME FINISH TOTAL TIME LESS BREAK AUTHORIZED CONSUMER SIGNATURE ACTIVITY RECORD Directions This is a legal document. Check the assignment/care plan* Check each activity that is completed* Indicate by R if an assigned activity is refused by the consumer. Use the comments section below for refusal reason* Consumer changes should be called to the supervisor. Use H for hospitalizations. ACTIVITY Bath Chair. Bed*. Tub Shower/Partial Bath Shampoo/ Hair set up Nail Care set up Dressing Oral Hyg/Dentures Shave set up Skin Care Lotion set up TOTAL HOURS CONSUMER NOTE By your signature you certify that hours shown are correct work was completed satisfactorily and you agree to the terms listed below. EMPLOYEE NOTE By your signature you certify that the hours recorded for the above dates are true and accurate and are properly verified by the client. Employee Signature Date Timesheets are due by 12 p*m* Monday. Please drop off fax to 267-639-9615 or email to timesheets sweethomehealthcare. com* You will NOT be paid without your timesheet. CONDITIONS Consumer agrees to terms of NET UPON RECEIPT and understands that unpaid accounts will be considered in default after thirty 30 days after which a default charge will be imposed at 1 per month on unpaid balances Annual rate of 18. or the legal interest whichever is lower. Client agrees to pay default charge and reasonable attorney s fee for cost of collection* Client recognizes the rights of Sweet Home HealthCare as the employer and agrees to NOT employ the person named herein for a period of 90 days following termination of this assignment unless assessment fee is paid* Fee is 2500. 00 for individuals 25 of projected annual wage for facilities. DO NOT pay the employee directly. No credit can be assured against the current invoice. Employee BONDING claims are only assured if claims are made in writing and to the local police within 14 days after notice of loss. FORM Foot Care set up Meal preparation Eating/drinking Laundry/Linen Light housekeeping Shopping Remind to take meds Reading/writing Social activities Telephone/devices Transportation/Escort Appt scheduling Personal possessions Seasonal clothing ROM Ambulating Supervised walks Supervise/coach/cue Transfers Bowel/bladder mgt.

Form timesheet_template englis... Contract Management Team 12/F., Fortis Tower, 7779 Gloucester Road, Wanchai, HK Hotline: +852 2830 0148 Fax: +852 2895 3673 contract.hk adecco.com (General Enquiry) timesheet.hk adecco.com (Timesheet)

Time sheet time sheet edway la... TIME SHEET ABN: 37 127 531 186 To avoid delay with payment, time sheet MUST be EMAILED (timesheets edwaylabourhire.com.au) or FAXED (02 9687 8490) by SUNDAY NIGHT of the working week. Subject heading

Timesheet attendant care palco... www.palcofirst.com Arkansas SDSB Biweekly Timesheet Make plenty of copies of this timesheet. This is the only timesheet that will be accepted. If you make a mistake, mark a single line through the

Ppl timesheet form PCG PUBLIC PARTNERSHIPS, LLC ATTENDANT TIME SHEET (Fiscal Intermediary for the VA DMAS & CCC Consumer Direction Programs) PPL Attendant ID: Service Type(fill one)Attendant 's Name:RespiteConsumer

Sunday end date form Timecards are due EVERY Monday before 10 am. We accept faxed or emailed timecards. For reference always keep a copy of the timecard. Timecards must be legible and completely filled out. Two signatures are required to have your timecard processed yours and the property managers. PROPERTY NAME SUNDAY END DATE ADDRESS CITY PRINT YOUR NAME 877 203-8667 timecards bgstaffing. com SOCIAL SECURITY NO. DAY DATE HOURS TO NEAREST QUARTER HOUR START LUNCH HOURS MON EMPLOYEE I CERTIFY THAT THE HOURS SHOWN HEREIN REPRESENT THE TOTAL HOURS WORKED THIS WEEK BY ME AND WILL BE ADVANCED BY BG STAFFING UNTIL PROPERLY VERIFIED BY THE CLIENT. 4 This agreement is entered into and performable in the State of Texas. In the event enforcement becomes necessary then venue will be in the courts of Dallas County Texas. DAY DATE HOURS TO NEAREST QUARTER HOUR START LUNCH HOURS MON EMPLOYEE I CERTIFY THAT THE HOURS SHOWN HEREIN REPRESENT THE TOTAL HOURS WORKED THIS WEEK BY ME AND WILL BE ADVANCED BY BG STAFFING UNTIL PROPERLY VERIFIED BY THE CLIENT. I AGREE TO CALL THE BG STAFFING OFFICE BETWEEN THE HOURS OF 8 00 AM AND 9 00 AM THE NEXT REGULAR WORK DAY FOLLOWING THE CONCLUSION OF MY ASSIGNMENT WITH THE CLIENT TO MAKE MYSELF AVAILABLE FOR NEW ASSIGNMENTS. I UNDERSTAND AND ACKNOWLEDGE THAT IF I FAIL TO DO SO BG STAFFING MAY ASSUME THAT I HAVE VOLUNTARILY QUIT WITHOUT GOOD CAUSE ASSOCIATED WITH WORK AND THAT SUCH A VOLUNTARY QUIT MAY RESULT IN MY BEING DENIED UNEMPLOYMENT BENEFITS. TUE DRAW LINE THROUGH DAYS NOT WORKED WED YOUR SIGNATURE THU X FRI CLIENT YOUR SIGNATURE REPRESENTS THAT YOU ARE IN AGREEMENT WITH ALL THE TERMS AND CONDITIONS ON FRONT AND REVERSE SIDE HEREOF AND THAT THE HOURS SHOWN ARE CORRECT AND THE WORK WAS COMPLETED SATISFACTORILY. FINISH SAT TITLE SUN QTR. HR. TOTAL HOURS PURCHASE ORDER NUMBER FORM BG - TC5001 REV 2/14 EMPLOYEE INFORMATION Employee Information NEVER CALL THE CLIENT IF YOU ARE LATE OR CANNOT WORK THE ASSIGNED HOURS CALL US. DO NOT CALL THE CLIENT. Performed in a satisfactory manner and Example Timecard Jane Doe Dallas 1 2 3 4 5 6 7 8 9 John Doe 1/18 1/19 1/20 ABC Property 1/21 1/22 1/23 1/24 DRAW 6 LINE CLIENT Mgr YELLOW COPY - EMPLOYEE 1212 Yellow Drive 1 24 10 PINK COPY - CLIENT WHITE COPY - BG STAFFING vices that - a The Client shall not entrust the Service s employees with cash. IT IS YOUR RESPONSIBILTY to get a signature from the client and turn in your time card in a timely manner. Payment shall be due within ten 10 days of Agency s invoice. If Customer employs directly or indirectly at any location or property owned or managed by the customer any individual submitted by Agency within 180 days of introduction Customer shall pay the fee to Agency.

Fin del periodo 15 28 30 31 in... Si trabaja en ambos periodos usted necesita entregar una tarjeta de tiempo por periodo y por cliente. Un buz n est disponible despu s de horas de trabajo y fines de semana para entregar tarjetas de tiempo. Quarter/Primer Trimestre 3rd. Quarter/Tercer Trimestre PAY PERIOD Periodos de Pago TIME CARD DUE Tarjetas de Tiempo se Vencen 01/01/17 - 01/15/17 01/16/17 01/31/17 02/01/17 02/15/17 02/16/17 02/28/17 02/15/17 02/28/17 03/31/17 Sun Tues Wed Fri PAY DATE D a de Pago 03/26/17 04/10/17 Thur Mon Tarjetas de Tiempo se Vencen 09/16/17 09/30/17 07/15/17 Sat 07/31/17 Mon 08/15/17 Tues 08/31/17 Thur 09/15/17 Fri 09/30/17 Sat 07/26/17 Wed 08/26/17 Sat 09/10/17 Sun 09/26/17 Tues 2nd. Com Pay Period Ending Circle One Circule uno Year A o Fin del Periodo IN-HOME RESPITE WORKER TIME RECORD Month Mes Look in the back of your time card to see when your time card is due / Revise al reverso de su tarjeta de tiempo para verificar cuando es la fecha limite para entregarla. Your time card is due even if the due date is a Saturday or Sunday / Su tarjeta de tiempo se vence aunque el d a de entregar sea s bado o domingo. Cuando el d a de pago cae en s bado domingo o d a festivo usted recibir su pago el siguiente d a h bil. 2017 HOLIDAYS no Respite is provided New Year s Day January 1 - Sunday Dr. Para proveer servicios de respite se requieren certificados vigentes de RCP y Primeros Auxilios de una agencia autorizada. Employee Signature/Firma del Empleado X Date/Fecha Comments/Corrections Authorized Office Signature Date In-Home Respite Worker Time Record PP -Inland 1-1-17 Title PAY PERIOD SCHEDULE 2017/PERIODO DE PAGO 2017 1st. NOTAS IMPORTANTES Cambio de Nombre Traer su nueva tarjeta de Seguro Social y su Licencia de Manejo con el cambio de nombre Cambio de Direcci n Llene la forma de Informaci n Personal de Empleado. INLAND RESPITE Indio Office 43430 Monroe Street Suite F Indio CA. 92201 Tel. 760 342-2290 Fax 760 863-1034 Preferred Provider indiopayroll invlrespite. I certify that respite was provided at the client s home. I Respite Worker certify that the hours shown above are correct and that I performed satisfactorily my duties and met the terms and conditions set forth in the respite regulations. Address Change Complete an Employee Personal Information form* If you worked on both pay periods you need to submit one time card per pay period per client. A drop box is available after hours and on weekends to turn in your time card. Parent/Caregivers are not allowed by Regional Center to give hours away that have not been worked* This is Fraud. Address Change Complete an Employee Personal Information form* If you worked on both pay periods you need to submit one time card per pay period per client. A drop box is available after hours and on weekends to turn in your time card. Parent/Caregivers are not allowed by Regional Center to give hours away that have not been worked* This is Fraud.

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