EmailMe Form - W2 Request Form

Store Number *

If your location is not listed, you may not use this form to request your W-2, please contact your company’s payroll department instead.

Email *

Employee Name *

First Last

Email to send W2

Year Requesting *

I certify under the penalty of law that I am the employee requesting this W2 or the employer on request of the employee *

Yes

No

Notes/Comments