ESS-C-801 SES Authorization Request & Billing Form (Rev 2022-02-08)

Form Number: 


The ESS-C-801 Supplemental Employment Services (SES) Authorization and Billing Request Form (2021-08-06) will be completed by the EC and submitted to the DRS Counselor when requesting the initial authorization and subsequent authorizations for the contract services. The EC will complete the form and submit it to the DRS Counselor at the completion of each service with all of the required documentation for payment.


File Origination or Revision Date: 

Rev 2022-02-08