DSHS Form 02-586 "Temporary Employment Hours Tracking Log" - Washington

What Is DSHS Form 02-586?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2009;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 02-586 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

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Download DSHS Form 02-586 "Temporary Employment Hours Tracking Log" - Washington

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Temporary Employment Hours Tracking Log
This information is only for capturing HISTORICAL employment hours, not for budgeting income.
CSO NUMBER
PARENT’S NAME
JAS ID
CLIENT ID
REPORT MONTH
DATE VERIFIED
TOTAL
HOW VERIFIED
EMPLOYMENT
CONTACT NAME/TITLE AND
AND DATE NOTE
NUMBER
(PHONE, TEMP
NAME OF EMPLOYER
STAFF PRINTED NAME/SIGNATURE
DATE(S)
PHONE NUMBER
ENTERED
OF HOURS
EMPLOYMENT
IN E-JAS
WORKED
FORM, PAY STUBS)
This information is only for capturing historical employment hours, not for budgeting income.
DSHS 02-586 (05/2009)
 
Temporary Employment Hours Tracking Log
This information is only for capturing HISTORICAL employment hours, not for budgeting income.
CSO NUMBER
PARENT’S NAME
JAS ID
CLIENT ID
REPORT MONTH
DATE VERIFIED
TOTAL
HOW VERIFIED
EMPLOYMENT
CONTACT NAME/TITLE AND
AND DATE NOTE
NUMBER
(PHONE, TEMP
NAME OF EMPLOYER
STAFF PRINTED NAME/SIGNATURE
DATE(S)
PHONE NUMBER
ENTERED
OF HOURS
EMPLOYMENT
IN E-JAS
WORKED
FORM, PAY STUBS)
This information is only for capturing historical employment hours, not for budgeting income.
DSHS 02-586 (05/2009)