Have I:

[] Used the most current invoice form?

[] Submitted an original invoice signed in blue ink?

[] If asking for mileage reimbursement, have I used the correct mileage rate?

(If you are unsure of the correct rate, you may call the receptionist at the Administrative Office at 304-558-0145. The rate as of January 1, 2015, is $.575.)

[] If I am requesting out-of-pocket expenses, have I attached original receipts?

[]Have I included a copy of the attendance sheet and the original class evaluations with my invoice? (Parent Educators only)

[] Have I included copies of the presenter invoices with my coordinator invoice?

(Coordinators only)

[] Have I requested the correct fee for my services?

(Parent education presenters: please refer to your independent contractor agreement. Parent education coordinators: please multiply 12% by the total of all presenter invoices)

[] Have I listed the county for which the service was performed?

[] If I am submitting three or more invoices, have I included a summary sheet totaling the charges, listing the counties for each service, and signed in blue ink?

[] Have I included a copy of the appropriate Independent Contractor Agreement(s)?

(Parent Educators, Security Guards and Coordinators Only)

[]Have I included the invoice number on my invoice? (Parent Educators, Security Guards, and Coordinators Only)

[] If my address has changed, have I enclosed a new W-9 form?

[] Have I sent my invoice to the right person and address? (Invoices for parent

education, Advanced Child-Focused Parent Education, mediation, Guardian ad Litem, and parenting plan home study evaluations go to:

Family Court Services Program Coordinator

WV Supreme Court of Appeals

1900 Kanawha Blvd., East

Building 1, Room E-100

Charleston, WV 25305

Updated 5/2015