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Form preview Public partnership timesheet 1... The PPL timesheet is single service which means if the Support Service Worker provides multiple types of service they will need to submit a separate timesheet for each service. B. Participant ID This ID is generated by PPL and will start with the letter C. C. Support Service Worker Name This is the name of the Support Service Worker who is providing services to the Participant for days worked on this timesheet. Public Partnerships LLC PA ODP Program 7776 S Pointe Pkwy W Suite 150 Phoenix AZ 85044 PPL Paper Timesheet Instructions PPL accepts paper timesheets by fax or mail. Timesheets are read by a machine like the ones that read standardized tests so it is important that you fill out these timesheets clearly and completely. Required Fields All of these fields MUST be completed for the timesheet to be paid* This list corresponds to the timesheet image above. A. Participant Name This is the name of the Participant receiving services. Please print the Participant s name clearly on the line. Page 1 of 4 E* Service Type Enter the approved procedure code/service based on the Participant s Individual Support Plan ISP. F* Week 1 Begin Date This is the first day of the pay period. Your pay schedule will list these dates for you. Please enter the first day of the pay period on this line even if you don t start work on this date. G* Week 2 End Date This is the last day of the pay period. Your pay schedule will list these dates for you. Please enter the last day of the pay period on this line even if your last date worked for the pay period was before this date. H. Time In Enter the time the Support Service Worker started working. I. Time Out Enter the time the Support Service Worker finished working. J* AM/PM Fill in the circle indicating if the Support Service Worker worked in the AM or PM. K. Date of Support Service Worker Signature This should be the date that the Support service on the dates worked* M. Date of Common Law Employer Signature This should be the date that the Common Law Employer reviewed and signed the timesheet. N* Common Law Employer Signature Signature of the Common Law Employer who reviewed and approved the timesheet. Special Situations 1. Working overnight When you work overnight you must complete one line for work you did before midnight and another line for work you did after midnight. For example say you worked overnight Friday night from 9 00 PM to 6 00 AM. Enter the start time as 9 00 PM as seen below. Enter the end time for that day as 11 59 PM. Now you did not finish working at 11 59 PM you just finished working on Friday at that time. Enter the rest of your time on Saturday as seen below from 12 00 AM to 6 00 AM. 2. Many SSWs work with someone multiple times in a day. You can enter two different in and out times on one timesheet but you must enter each on a separate line. If you need to enter more than two in and out times for the same day you will need to move onto a second timesheet for the same pay period. left to run an errand came back at 11 15 AM and stayed until 12 30 PM. You would enter one line for each time you were providing services as shown below.

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