Time and Effort Reporting Form
Adopted: 8/9/2023
In order to comply with the (Federal Program) Grant requirements for “time and effort reporting,” this form must be completed near the end of each (month/quarter/semester/school year) by each salaried faculty member paid entirely by, or a portion by, (Federal Program) Funds.
Employee Name _____________________________________________________________ School ___________________________________________________________
Report for (Month/Quarter/Semester/School Year)________________________________________________________________________________
Portion or Percentage of Contract Paid by (Federal Program) ______________________________________________________________________
In compliance with the requirements of OMB Circular A.87 and (Federal Program), I hereby certify that this report is an after-the-fact determination of actual effort expended for the period indicated, and I have full knowledge of 100% of these activities.
Employee Signature ___________________________________________________Date _______________________________________________
Supervising Administrator Signature ____________________________________________ Date_______________________________________
Please return this completed form no later than 10 days after the close of the reporting period to the supervising administrator.
If you have questions, you may contact Arlene Anderson, Aaron Peterson, or Jake Hill at the District Office at 435-835-2261.
