HUMAN RESOURCES SERVICES
Sign Date
01/27/2014
Oklahoma Department of Public Safety
Sign
01/27/2014 160
01/27/2014
We will complete the rest of this form.
For your records…
For your records…
PAYROLL
Sign
01/27/2014 Leave Blank
Sign
01/27/2014
Leave Blank
Provide another number
Sign Print 01/27/2014
Leave Blank Print