"Certification of Hours Compliance Checks" - New Jersey

Certification of Hours Compliance Checks is a legal document that was released by the New Jersey Department of Law and Public Safety - Office of The Attorney General - a government authority operating within New Jersey.

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Download "Certification of Hours Compliance Checks" - New Jersey

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STATE OF NEW JERSEY
DIVISION OF ALCOHOLIC BEVERAGE CONTROL
Enforcing the Underage Drinking Laws Grant Program
CERTIFICATION OF HOURS
Compliance Checks
Name of Agency:___________________________________ Subgrant Award Number: ______________
NAME OF OFFICER
HOURLY
DATE OF
LOCATION/NAME OF
NUMBER
AND BADGE NUMBER
O.T. RATE
ASSIGNMENT
ESTABLISHMENT
OF HOURS
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
CERTIFICATION BY RECEIVING AGENCY: I CERTIFY
THAT THE ABOVE SERVICES HAVE BEEN RENDERED
____________________________________________
AS STATED HEREIN.
SIGNATURE
_____________________ _______________________
TITLE
DATE
Forward to Kelly Troilo, on a weekly basis, at: Division of ABC, PO Box 087, Trenton, NJ 08625-
0087.
*
Copies should also be included with each Quarterly Report.
STATE OF NEW JERSEY
DIVISION OF ALCOHOLIC BEVERAGE CONTROL
Enforcing the Underage Drinking Laws Grant Program
CERTIFICATION OF HOURS
Compliance Checks
Name of Agency:___________________________________ Subgrant Award Number: ______________
NAME OF OFFICER
HOURLY
DATE OF
LOCATION/NAME OF
NUMBER
AND BADGE NUMBER
O.T. RATE
ASSIGNMENT
ESTABLISHMENT
OF HOURS
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
CERTIFICATION BY RECEIVING AGENCY: I CERTIFY
THAT THE ABOVE SERVICES HAVE BEEN RENDERED
____________________________________________
AS STATED HEREIN.
SIGNATURE
_____________________ _______________________
TITLE
DATE
Forward to Kelly Troilo, on a weekly basis, at: Division of ABC, PO Box 087, Trenton, NJ 08625-
0087.
*
Copies should also be included with each Quarterly Report.