ESS-C-398 SE Authorization Request & Billing Form (Rev 2022-09-23)

Form Number: 

ESS-C-398

The EC will complete the ESS-C-398 SE Authorization Request & Billing Form to request authorization to begin providing service for each milestone and will submit with required documentation for payment at the completion of each milestone.
For use with Supported Employment Contract (SEC)

Document: 

File Origination or Revision Date: 

Revised 2022-09-23