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* Worksite

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* Employee First and Last Name (Participant worker)

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* Employee Work Week (in current pay period)

Date
Date

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* Employee Hours Worked

  Hours Minutes
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

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* Submitter Information

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* I have reviewed these hours with the employee and verify my submission is true

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* Is this is a resubmission of previously entered hours?

T