Request For Irs Form W-2
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1REQUEST FOR IRS FORM W-2
PLEASE READ THE ENTIRE FORM BEFORE COMPLETING
W-2 forms more than 7 years old are not available. All W-2 forms starting tax year 2011 are available through Self-Service; use
the following link to access instructions and form milwaukee.gov/selfservice. For all other forms, they will be available within 5
working days from the date of receipt in the Office of the Comptroller. This request includes any and all applicable W-2c forms.
The Milwaukee Code of Ordinances sections listed below govern the issuance of these forms:
Section 81-132
Wage and Tax Statement Duplicates. 1. Upon written request, one copy or duplicate set of wage
statements (W-2 form) shall be provided to current or former city employes without charge through April 15 for the
preceding calendar year. 2. The processing charge for requests beyond April 15, or for additional copies or duplicates
shall be $10 and $15 respectively for each item requested
Section 304-37
Bad Check Charges. There may be a processing charge for any check or order issued to the city of
Milwaukee or any department thereof and returned unpaid by a bank due to insufficient funds or due to any other
reason. Bad check charges shall be paid into the city treasury and credited to the general city fund.
Section 81-19.5
Checks; Bad Check Charges. The processing charge for each bad check issued to the city of
Milwaukee shall be $35.00
Consent to Payroll Deduction for Insufficient Funds
As the maker of this check or order, I hereby declare my consent that my employer, the City of Milwaukee, may deduct from my
net pay the amount of any insufficiency of funds for this check or order, plus a $35.00 processing charge (Sec 304-37; 81-19.5)
Initial here ________
MAIL TO:
OFFICE OF THE COMPTROLLER
ATTN:
PAYROLL ADMINISTRATION
200 E. WELLS STREET, ROOM 404
MILWAUKEE, WI 53202-3566
Please issue a Reissued Statement of Form W-2 for the tax year(s) ending __________. ($15 for each year requested)
Make payment payable to: City Treasurer.
THIS FEE IS NON-REFUNDABLE
FORM W-2 is requested for the following reason: ______ Lost
______ Destroyed
______ Never Received
PLEASE PRINT
EMPLOYE NAME
SOCIAL SECURITY NO.:
PHONE NO.:
(
)
/
/
CURRENT MAILING ADDRESS:
Street Address
City
State
Zip Code
DEPT/LOCATION:
EMPLOYE ID:
(For each year W-2 or W-2c was issued, not current DEPT/LOC No.)
Mail ______ Call for Pickup __________________
__________________________________________________
Employe Signature
Date of Request
FOR COMPTROLLER’S USE ONLY:
PROCESSED BY:
Date:
/
/
Mailed on:
/
/
Called on:
/
/
Payment by:
Cash
Amount $:
Picked up by:
Check or Money Order No.
C-403 r7 10/14/16
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