Timesheet

Important Form Information:

Please indicate the number of hours per day that you participated/worked in each of the acceptable work activities and if applicable have 3rd party signature on activity verified line. When completed return to your Family Advocate with your MER by the 5th day of the month.

Remember to attach all proof of work hours and income to the Monthly Eligibility Report!

An email address and phone number are necessary to complete the form. If you do not have an email address, please contact the office for assistance. For additional assistance regarding this online form, please contact the office.