Manual Payroll Submissions - AIM Services, Inc.

Staff Name(Required)

Individual(Required)

Service(Required)

Date(Required)

Shift Time (start)(Required)

Shift Time (end)(Required)

Why the punch was not documented via EVV standards(Required)

Physical location of start time(Required)

Street Address Address Line 2 City State ZIP Code

Where was the clock in location?(Required)

Physical location of stop time(Required)

Street Address Address Line 2 City State ZIP Code

Where was the clock out location?(Required)

Valued Outcome worked on:(Required)

Prompting(Required)

Individual Response(Required)

Service Notes(Required)