Employee Time Report Form, DEP Box 32, Dec 1994

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ENTRY r EVENT DATE ENTRY1 [ EVENT TIME mzm 1 am [ :r^ ] AGENCY REPORTWW SALARVOIFF. TYPE czaa I DAV I I YEAR TYPE I [Ll’i'ZI DATA CATEGORY ] St DOLLARS I I CENTS I I PAY BP

oil’ll I IfellolTl I ilvlolo] 0 shblol □ m • mm □ NEW ¥71071071 0025 OS : O 0 Al mm □ I OLD 5017007] 0000 0003 [ m 0] SEirn □ NEW 02 07] 071 1102191 0303 1 01 ITU ] □ I OLD [THmH UH® 03 3 : O ] 01 nzrm □ Fn^ TO 071071 0202 0102 rnri [ ] 01 mm □ [ OLD Ittiqllilfellalil 0503 StFSS □ □ I ] 00 mm □ [ NEW 0^(70071 0320 0a03 rnri i I ] 00 mm □

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 DOCUMENTATJI0N ON FILE , ADJUSTMENT TRANSACTp©l<,-r——— INTOPMS ____ ________ *>^*^*0^*^ SIGNATURE SIGNATURE z signature If -td DATE DATE DATE