W-2 Request Form printable pdf download

W-2 Request Form

W-2 Reprint Requests must be received in writing or by email at:

payroll@mitchellhamline.edu.

Written requests will be processed within 72 hours.

Date of Request:_____________Tax year: _____________

Name: _______________________________________________

Last 4 digits of Social Security Number: ___________

Please choose one of the following:

1. I will pick up the reprinted W-2 in the Finance Office (Room 276 LEC Building).

Notify me when the form is available by:

Calling me at ___________________________

Email me at ___________________________________________

2. Please mail my reprinted W-2 to the below mailing address.

Street:__________________________________________________

_______________________________________________________

City:_________________State:_____ Zip:____________________

Finance Office Use Only:

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Date Processed:

Initial here:

Action Taken:

Mailed out returned W-2

Reprinted W-2

Other

W-2 Request Form