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The Arc of East Central Iowa
Time Sheet
Period Ending:
680 2nd Street SE, Suite 200
Hourly Employee
Due Date:
Cedar Rapids, IA 52401
Ph: 319-365-0487
Message Center:
Fax: 319-365-9938
Date of Start End Consumer Name/Program Service
Service Time Time (use full correct legal name) Type Earn Docum./
mm/dd/yy hh:mm hh:mm Last Name, First Name
(Resp, SCL, etc.)
Type Signed
_________________________ __________ _________________________ __________
Employee's Signature Date Agency Reviewer Date
Employee #
City, State , Zip
DSP Level:
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Timesheet Hourly Template
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