Employee Time Report Form, DEP Box 32, Dec 1994

NYC 9/11 Public Portal Document

T. 5 CITY OF NEW YORK PAYROLL MANAGEMENT SYSTEM EMPLOYEE TIME REPORT FISA FORM PMSF 13(t2»4) ADJUSTMENT DOCUMENT NO. SOCIAL SECURITY NO. CD JSN WORK UNIT

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LAST NAME

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cUUHol^l I I I I I I I I M d crp 8 ENTRY rCZZl EVENT PATE ENTRY I EVENT TIME I AGENCY I r REPORTING SALARY DVF. SUFFL I r TYPE I DAV T1 YEAR TYPE CZZl I data I I CATEGORY 1 Bl DOLLARS I I CENTS I PAY SO

I OLD LJJUJLLI mn EXE 1 [ 1 Erm I NEW 17017171071 l/|g.|-?|o| 071-1710 ] Em I □ I OLD l/|o||/|g||o|zl 13703 EzF0 0 11 ] Eim I [70l/~[^[371 |o|z|g|g1 0710^ ] nm I □ □jELiin com [IB ] Em 0070071 S@0Z] ERBEE 1 nm □ OLD LULum rrm miL I 1 Eim □ I NEW 170170170 0323 07107 I 1 D ] am o □ 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 DOCUM^ATION FILE MTOPMS

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DATE —/ 2/06/0/ DATE DATE

NYC-WTC_000159073