PARENT COORDINATION INVOICE FORM Use this form to summarize all parent coordination cases this month Month MUST BE POSTMARKED BY THE 10TH OF NEXT MONTH. Dept. ID 2120030313 Fund 10000 Program Code 19322 Year Activity Code 1 meeting or telephone conference with parent 3 meeting with child ren 4 hearing or conference at courthouse 5 documentation Parent Coordinator Street Address City State Zip Social Security NOTE IF THIS IS THE FIRST BILLING FOR A CASE PLEASE HIGHLIGHT THE DOCKET NUMBER* Docket Number Co. Parent Amount of Time Spent Per Activity - see code above in hours Amount of Time Spent Subsidy for all Rate activity Hours Total Owed For This Case Total Final Billing for This Case Yes No Party 1 Sub Total time spent Payable If this is a final billing please enclose a case data information form* Date Statewide Coordinator 10/08 SML. Dept. ID 2120030313 Fund 10000 Program Code 19322 Year Activity Code 1 meeting or telephone conference with parent 3 meeting with child ren 4 hearing or....
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How to fill out the Parent Coordination Invoice Form online
Filling out the Parent Coordination Invoice Form online is a straightforward process that ensures accurate billing for parent coordination services. This guide will walk you through each section of the form, providing clear instructions and tips to help you complete it efficiently.
Follow the steps to complete the Parent Coordination Invoice Form.
- Click the ‘Get Form’ button to obtain the form and open it in your editor.
- Select the month for which you are billing. Clearly enter the month in the designated field.
- Indicate the year in the appropriate section by filling in the year next to the month.
- Fill in the department ID, fund, and program code as provided. These are crucial for tracking and processing your invoice.
- If this is the first billing for this case, highlight the docket number in the specified field.
- Enter your personal details as the parent coordinator, including your name, street address, city, state, zip code, and social security number.
- Record the amount of time spent on each activity by selecting the appropriate activity code and inputting the corresponding hours spent.
- Calculate the subsidy for all activities based on the total hours multiplied by the rate. Enter this amount in the provided field.
- Sum up the total owed for this case and write the final amount in the relevant section.
- Indicate whether this is final billing for the case by selecting 'Yes' or 'No'. If you select 'Yes', remember to enclose a case data information form.
- Sign and date the form at the bottom in the specified spaces for both the parent coordinator and the statewide coordinator, if applicable.
- Once completed, save any changes, and use the options available to download, print, or share the form as needed.
Take action now and complete your Parent Coordination Invoice Form online for faster processing.
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