Request For Historical T2202a Tax Form
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1REQUEST FOR HISTORICAL T2202A TAX FORM
Pre - 2013
FEE: $10.00 PER YEAR REQUESTED *ALL PROCESSING FEES NON-REFUNDABLE*
PLEASE PRINT CLEARLY
STUDENT INFORMATION
Last Name: ______________________________ First Name: _________________________________
Previous Name(s): ________________________ Phone Number: ______________________________
Current Address: ______________________________________________________________________
_____________________________________________________________________________________
Birth Date: ______/_______/_______ Student Number (if known):
Day
Month
Year
Please provide information regarding the tax form(s) you require.
Year(s) Required:
_____________________________
Print form and return to the Corporate
Cashier’s Office.
Mail: Corporate Cashier’s Office, Fleming
Number of Years Requested: _______ x $10.00 per year
College. 599 Brealey Drive, Peterborough,
ON K9J 7B1
Total Fees Remitted: $_____________
Secure Fax: (705) 749-5507
Delivery Method: Please choose one of the following
Pick up at Peterborough Cashier’s Office
Mail (to address above)
Mail to designated recipient: __________________________________________________
Email Address: _____________________________________________________________
Fax: _________________________/____________________________________________
Fax Number
Attention to:
Signature: ____________________________________ Date: ______/_______/_______
Day
Month
Year
Student records are confidential and T2202A’s are re-issued only upon written request and authorization of the student.
T2202A’s will not be processed if any fee balance and/or other obligation to Fleming College is outstanding or payment does not accompany the request. Normal
processing time for re-printing is 10 business days from receipt of request.
PAYMENT METHOD:
CHEQUE
MONEY ORDER
VISA
MASTERCARD
AMOUNT: $ _________
CREDIT CARD #: _____________________________________ EXPIRY DATE: _____ /_____
CARDHOLDER’S SIGNATURE _____________________________
*CREDIT CARD PAYMENTS WILL BE ACCEPTED BY FAX OR IN PERSON. DO NOT MAIL OR EMAIL CREDIT CARD INFORMATION.
**PLEASE MAKE CHEQUES AND MONEY ORDERS PAYABLE TO FLEMING COLLEGE.
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Parent category: Business