DEATH CERTIFICATE LoDI CORRECTION FORM One Year Per Form FORM 1099R RETIREES ONLY 1127 STATEMENT Fax or mail form and supporting documentation to FAX 212 669-4928 WWW.NYC. GOV/PAYROLL OFFICE OF PAYROLL ADMINISTRATION W-2 ADJUSTMENT UNIT 1 CENTRE STREET - ROOM 200 NORTH NEW YORK NEW YORK 10007 Wages other compensation Federal income tax withheld FOR OPA USE ONLY Social security wages Medicare wages and tips Medicare tax withheld Advance EIC Payment Dependent care benefits CONTROL NO 02 DATE P ...
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