I HEREBY CERTIFY that the persons named in this payroll certification are employed solely in and have actually performed the proper duties of the positions and employment indicated and are members of an appropriate retirement system when mandated by the Retirement and Social Security Law, and that the persons described herein as "laborers" are employed at ordinary unskilled labor only.

Said payroll for the payroll period of ______________________ is approved at

__________________________________ dollars, $________________________, and is certified for payment from the appropriations authorized; and that the persons named herein, except those appointed and employed as laborers, have taken and filed the Constitutional Oath in accordance with the provisions of Chapter 573, Laws of 1917.

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TITLE______________________________________________________________

DATE______________________________________________________________

I HEREBY CERTIFY that, with the exceptions shown, the employees named in this payroll certification, containing _________ names, have been appointed to or employed in the positions, places, and at the rates of compensation shown, in accordance with the civil service law and the rules made in pursuance thereof, and are certified through ____________________ unless otherwise noted. But when any person whose name appears on the certification has been separated from the service or if status changes in any way, this certificate shall apply to that person only up to the time such separation or change occurred.

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TITLE_____________________________________________________________