THE CITY OF NEW YORK
PAYROLL MANAGEMENT SYSTEM EMPLOYEE TIME REPORT
FISA FORM PMSF «3(12«4)
ADJUSTMENT
DOCUMENT NO. SOCIALSECURITYNO CD JSN WORK UNIT
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_____________ PREPARER MANAGER/SUPERVISOR KEY ENTRY OPERATOR
I CERTIFY THAT THE ABOWE ADJUSTMENTS ARE I CERTIFY THAT I HAVE REVII THE I CERTIFY THAT THE ABOVE DATE WAS ENTERED
SUPPORTED BY DOCUMENTATION ON FILE/ ADJU^^TT^JSACl^ INTO PMS
SIGNATURE SIGNATURE
DATE DATE DATE
NYC-WTC_000159053
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NYC-WTC_000159053Source: NYC Law Department, mirrored locally