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 FORM PMSF 13(12»4) ADJUSTMENT

□ DOCUMENT NO. SOCIAL SECURITY NO. CD JSN WORK UNIT

ruiT I Pll ] 0 Mol old LAST NAME FIRST _____________

'LleJoInloJcId I M S of 8 ENTRY [ EVENT DATE 1 [ ENTRY I EVENT THig AGENCY REPORTING SALARY DIFF. SUPPL I I I CENTS I TYPE L-'Jiii I DAY I 1 YEAR | [ TYPE Ezna :Tmin DATA CATEGORY 61 DOLLARS PAY INO I

I OLD ] LioJtNIolil SE50 SEIS OJO □□ rn □ I NEW 'lol ram HaBH EELEE □n mi □ I I LlJI I ] [ ETT BO m I NEW rnrruT] □ □ I nn rn □ OLD □JI I [ n nn n NEW I mi n nn □ ] □ OLD ] njnjuj □ ] m □ nn m □ NEW ] mmm □ □Ji n I I nn rn □ PREPARER MANAGER/SUPERVISOR KEY ENTRY OPERATOR I CERTIFY THAT THE ABOVE ADJUSTMENTS ARE I CERTIFY THAT I HAVE REVIEWED THE ABOVE I CERTIFY THAT THE ABOVE DATE WAS ENTERED SUPPORTED BY DOCI ATION ON ADJUS' INTOPMS

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DATE DATE DATE

NYC-WTC_000159031