Fillable Time-and-Effort-Form DISTRICT TIME AND EFFORT DOCUMENTATION FORM

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Time-and-Effort-Form DISTRICT TIME AND EFFORT DOCUMENTATION FORM

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Pasadena City College
Monthly Time and Effort Documentation Form
(GRANT-FUNDED EMPLOYEES)
This form is to be completed at the end of each MONTH.
GENERAL GRANT INFORMATION:
Name of Funding Agency: U.S. Department of Education Name of Grant:
Grant/Contract #: Grant Period:
Name of Employee:
Compensation percentage from each source (complete all that apply):
GRANT FUNDS _____% OTHER FUNDS ____% STIPEND _____Hours
TIME AND ATTENDANCE FOR GRANT FUNDED WORK
Certification Period: FROM: THROUGH:
Type of Schedule: ___ Daily ___ Weekly ___ Biweekly X Monthly
Program or Cost Objective
Distribution of Time
TOTAL
JOB OBJECTIVES COMPLETED:
I certify that I performed work consistent with the job objectives and as distributed in the above percentage during the Certification
Period.
SIGNATURE OF EMPLOYEE: _____________________________________________________________ Date: ________
Printed Name of Employee: _________________________________________________________________
I certify that I have firsthand knowledge that the above employee performed work consistent with the job objectives and as
distributed in the above percentages during the Certification Period.
SIGNATURE OF SUPERVISOR: ___________________________________________________________ Date: ________
Printed Name of Supervisor: ________________________________________________________________
(Note: Please attach supporting documentation as applicable – copies of time sheets.)
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Time-and-Effort-Form DISTRICT TIME AND EFFORT DOCUMENTATION FORM

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Completed 3 January 2020

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