1797 Pitkin Avenue Brooklyn, NY 11212 Tel :
5166000122, Fax : 5166000122
TIME AND ACTIVITY RECORD (DUE EVERY Friday)
Pending Pre-billing Sheet
I certify that the
supplied information is accurate, the hours shown represent my total hours worked in this assignment
during the week and they are properly verified by the participant or authorised repsresentative.
Checks will not be released without completed and signed activity record!