Verification Letter of Service Hours Request Form

Community Service Hours Section
Are you completing service hours for?*
How many Community Service were you mandated to complete?
How many volunteer hours were you are you expected to complete?*
How many Community Service hours have you completed so far?*
How many volunteer hours have you completed so far?*
How many Community Service hours should be listed on your verification letter?*
How many volunteer hours should be listed on your verification letter?*
Have you verified your hours on the Hands on Atlanta platform? A discrepancy in hours MUST be addressed before a verification of hours letter can be sent.*

YesNo
Are all hours correct on the Hands on Atlanta platform and/or your timesheet?*

YesNo
If there is a discrepancy in your recorded hours, please upload your timesheet(s) if applicable or any supporting documentation so we can review and investigate the issue. Clear photos only.

Cancelof
The photo(s) I am submitting is clear, legible, and not blurry.*

YesNoNot Applicable

Letter Details
What is the name of your probation officer or the name of the person requesting the letter? *

First NameLast Name
What is the name of the person requesting the verification letter?*

First NameLast Name
If it is a business, court system, etc. requesting the verification of hours letter please fill in the box with the appropriate name.
If it is a business, church, school, etc. requesting the verification of hours letter please fill in the box with the appropriate name.
What is their phone number?*
Please enter a valid phone number.
What is their email address?*
example@example.com
Who should the verification of hours letter be addressed to (i.e., who should be listed after “Dear” on the letter)?*
When are you required to have this letter compeleted by? (Cannot be today's date) Must be at least 48 hours later.*

MonthDayYear
Date
Please utilize this space if you need to let us know anything.
Verification letters are sent via email within 24–48 hours. You will be copied on the email for your records.

Please note that if there is a discrepancy in your recorded hours, a verification letter will not be issued until the discrepancy has been resolved. Once valid supporting documentation is provided, these matters are typically resolved promptly.

Your signature below confirms that you understand.
Signature*

Powered by Jotform SignClear
Should be Empty:

Community Service Hours Section