NYC Payroll Management System employee time report form, 1994

NYC 9/11 Public Portal Document

THE CITY OF NEW YORK PAYROLL MANAGEMENT SYSTEM EMPLOYEE TIME REPORT FISA FOmi PMSF 13(12«4) ADJUSTMENT

□ DOCUMENT NO. SOCIAL SECURITY NO. CD JSN

mu WORK UNIT

Pll 7 t>|o|o|o| LAST NAME_________ __________

•vIvl'CfT qIaI LLU FIRST

Lklolnlolr IaI I I I □ Ml 6 of 8 EVENT DATE [ EVENT TIME ENTRY TYPE I [ T DAV I I YEAR I ENTRY TYPE IIES3! AGENCY DATA REPORTING CATEGORY ST SALARY DIFF. DOLLARS _____ I I CENTS SUPPL I PAY wo I

I OLD ] Iflial laliil bld' MS SMI FTm HI ] l-ll I I I □ J NEW ] loHI blul loll I li bblol IoItI'IoIoI [ LU ] ni 1111 im m loHIlalulbli 1 ] 0 nn □ I new I iohimUil hlalalol o rrm in ] ni 1111 im □ I OLD ] loHllalfeilolil 11503 0103 □ □n ] UI .u m □ NEW ] 1^15003 LSKH UUm □ □ rn ] ni 1111 im OLD ] lol si lalfel in mold lola|-|o|o| LU ] UI |NEW ] immoU I Lam m-m □ ] All 11 urn

PREPARER MANAGER/SUPERVISOR KEY ENTRY OPERATOR I CERTIFY THAT THE ABOVE, ^ENTSARE I CERTIFY THAT I HAVE REVIEWED TIC ABOVE I CERTIFY THAT THE ABOVE DATE WAS ENTERED SUPPORTED BY DOCUMENT! ON FILE ADJUS' TRANSACTION INTO PNC

SIGNATURE r SIGNATURE signature

// DATE DATE DATE

NYC-WTC_000159028