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DATA CORRECTION FORM (CANDIDATE’S USE ONLY)

HUMAN CAPITAL The David N. Dinkins Municipal Building One Centre Street, New York, NY 10007 DP 148A (Rev. 6/2017) data CORRECTION form ( candidate S USE ONLY) THIS form IS BEING USED TO CORRECT/CHANGE: (CHECK ALL THAT APPLY) SOCIAL SECURITY NUMBER NAME ADDRESS TELEPHONE NUMBER EMAIL ADDRESSINSTRUCTIONS FOR USING THIS FORMP lease review and answer the following questions before using this form 1. Are you using this form to update your mailing address on file with DCAS? YES NO If you answered YES, please answer question 2 below. If you answered NO, you may use this form and submit as directed. 2. Are you currently employed by the City of New York? YES NO If you answered YES, please answer question 3 below. If you answered NO, you may use this form as directed. 3. Do you have access to Employee Self Service (ESS)? YES NO If you answered YES to questions 1, 2, and 3, DO NOT USE THIS form .

HUMAN CAPITAL The David N. Dinkins Municipal Building One Centre Street, New York, NY 10007 DP‐148A (Rev. 6/2017) DATA CORRECTION FORM (CANDIDATE’S USE

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