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Employee Time Report Form, DEP Box 32, Dec 1994

Machine-extracted title · confidence 90%

Blank FISA Form PMSF 13 employee time report form for the World Trade Center site.

NYC-WTC_000159044–000159046

Folder label: “WTC

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Scanned page image, NYC-WTC_000159046
OCR text

OCR status: ok · source: pdftotext

z z -< o THE CITY OF NEW YORK g PAYROLL MANAGEMENT SYSTEM EMPLOYEE TIME REPORT to

o I o o FISA FORM PMSF ,3(12«4) ADJUSTMENT “0 c CT o o' cn DOCUMENT NO. SOCIAL SECURITY NO. CD JSN WORK UNIT "0 co o o O) E T3 2333 03

o LAST NAME FIRST Ml o o rammoTQ mo 03ZI1EOQ on c 3 CD 3

r EVENT DATE ENTRY TYPE mill I DAY I I YEAR ENTRY TYPE n EVENT TME :l MIN AGENCY DATA ] REPOTTING CATEGOTY En SALARY DIFF. DOLLARS ______ I I I CENTS I SUPH. PAY INO

OLD [0Olios- [ I □ QI WB* I 0220 loomi m Q QI non □ I PCD I n im n I m Q QI mia □ NEW [ u im rm m n m Q QI mn □ OLD mmm i m□ □ Ell mi □ NEW n 1mm i I ] I QI in □ r^3 Q nm □ □ I im 0 1 m m QI mi □ mom □ ICQ Q m QI H Hl □ PREPARER MANAGER/SUPERVISOR KEY ENTRY OPERATOR I CERTIFY THAT THE ABOVE AIWSTMENTS ARE I CERTIFY THAT I HAVE REVIEWED I CERTIFY THAT THE ABOVE DATE WAS ENTERED SUPPORTED BY DOCUMENWpfDN ON FILE - ADJUSTMENT INTOPMS

SIGNATURE SIGNATURE SIGNATURE

DATE DATE DATE

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NYC-WTC_000159046Source: NYC Law Department, mirrored locally

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