Employee Time Report Form, WTC, DEP Box 32

z -< z THE CITY OF NEW YORK o -< o payroll management SYSTEM EMPLOYEE TIME REPORT 5S

s ADJUSTMENT c '2 FISA FORM PMSFt3tl2»4)

o'

□ o DOCUMENT NO. SCyiALSECUFUTYNO. CO JSN WORK UNIT o "0 cn LULEU 0 IUH3 o CD o ro o LAST NAME

M«-IV>leULU I I I I I I I I RRST

ISh^kkld I I I I I 1 1 I □ Ml 1 03 o o o c 3 a> 3

I ENTRY I [ EVENT DATE ENiRY I EVENT Tl>g ] IAGENCY REPORTING SALARY DIFF. ] I SUPPL I I TYPE I [CZSHl I PAY I 1 YEAR TYPE IEE3' J I DATA [ CATEGORY ] El DOLLARS I I OLD ] EETWHZI 0333 0303 □ I □ 0LU 1 □ . I NEW Lm im mi 0320 133133 n I □ nru I □ cm 0303133 0330 0303 □ I [ 1 ULU nm 0210303 0333 0303 0 ] Eim I J LU LU LU LUU LULU □ I 1 Enu I NEW ] Lonuu mu lulu □ I ] uu I I OLD ] LU LU LU LUU LULU □ 1 ULU I NEW ] LULUUZI LUU LULU □ ] nru

PREPARER MANAGERZSUPERVISOR KEY ENTRY OPERATOR ‘ I CERTIFY THAT THE I ARE I CERTIFY THAT I HAVE REVIEWED THE ABOVE I CERTIFY THATTHE ABOVE DATE WAS ENTERED SUPPORTED BY DOO 'ATIQNON INTOPMS

SIGNATURE SIQNATURE SIQNATURE

DATE DATE DATE