Cpse Seit Provider Monthly Timesheet

ADVERTISEMENT

The Children’s Center for Early Learning
83 Marlborough Road
Brooklyn, New York 11226
CPSE SEIT PROVIDER MONTHLY TIMESHEET
Billing Month/Year: May 2011
Provider Name: _________________________________________________________
Name of Child: _______________________________
D.O.B.: ________________
Weekly Mandate: ___________ NYC I.D#: _____________
Service Location (Please check one): Queens Brooklyn Bronx Manhattan Staten Island
Dates of
Time In and
Length
Session
Absence Codes
Service Location
Verifying Signature
Service
Time Out
of
Provided
Session
If make-
# of
*Check
C = Site Closed
H = Home
Parent, Teacher, or Director,
A = Child Absent
S = School
up
hours
box only if
etc. must sign after each
P = Provider Absent
D = Day Care
session,
session
session is held, NOT AT THE
write in
was
V = Provider on
O = Other
END OF THE MONTH.
MU next
provided
Vacation
N = Holiday
to the
date
(include
absences)
Circle appropriate
Circle appropriate
code below:
code below:
IN
OUT
5/2/11
C
A
P
V
N
H
S
D
O
C
A
P
V
N
H
S
D
O
5/3/11
C
A
P
V
N
H
S
D
O
5/4/11
C
A
P
V
N
H
S
D
O
5/5/11
C
A
P
V
N
H
S
D
O
5/6/11
C
A
P
V
N
H
S
D
O
5/9/11
5/10/11
C
A
P
V
N
H
S
D
O
5/11/11
C
A
P
V
N
H
S
D
O
5/12/11
C
A
P
V
N
H
S
D
O
5/13/11
C
A
P
V
N
H
S
D
O
5/16/11
C
A
P
V
N
H
S
D
O
5/17/11
C
A
P
V
N
H
S
D
O
5/18/11
C
A
P
V
N
H
S
D
O
5/19/11
C
A
P
V
N
H
S
D
O
5/20/11
C
A
P
V
N
H
S
D
O
5/23/11
C
A
P
V
N
H
S
D
O
5/24/11
C
A
P
V
N
H
S
D
O
5/25/11
C
A
P
V
N
H
S
D
O
C
A
P
V
N
H
S
D
O
5/26/11
5/27/11
C
A
P
V
N
H
S
D
O
School closed.
5/30/11
C
A
P
V
N
H
S
D
O
5/31/11
C
A
P
V
N
H
S
D
O
Total # of Hours Provided 
****Shaded areas indicate school closed – no service****
Service Provider Signature: ______________________________
Date: _________________________

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go