W-2 RE-ISSUANCE REQUEST FORM
W-2 RE-ISSUANCE REQUEST FORM NOTE: There is a 24 hour processing period on all requests * ID must be presented when picking up * There is a $15.00 fee for any re-issuance of duplicate W-2 VI forms Date: _________________ EMPLOYEE INFORMATION Name: __________________________________ Employee Number: __________________________________ Telephone Number: __________________________________ SSN: __________________________________ Email Address: __________________________________ Job Title: __________________________________ Activity Site: __________________________________ Address: __________________________________ Employee Signature: ____________________________ FOR HR OFFICE USE ONLY Prepared By: ________________________ Date Issued: ________________________ Comments: ___________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Knud Hansen Complex Bldg. A • 1303 Hospital Ground, Suite 1 • St. …
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W-2 RE-ISSUANCE REQUEST FORM NOTE: There is a 24 hour processing period on all requests * ID must be presented when picking up * There is a $15.00 fee for any re-issuance of duplicate W-2 VI forms Date: _________________ EMPLOYEE INFORMATION Name: __________________________________ Employee Number: __________________________________ Telephone Number: __________________________________ SSN: __________________________________ Email Address: __________________________________ Job Title: __________________________________ Activity Site: __________________________________ Address: __________________________________ Employee Signature: ____________________________ FOR HR OFFICE USE ONLY Prepared By: ________________________ Date Issued: ________________________ Comments: ___________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Knud Hansen Complex Bldg. A • 1303 Hospital Ground, Suite 1 • St. Thomas, Virgin Islands 00802-6472 • (340) 774-0930 3011 Golden Rock • Christiansted, St. Croix, Virgin Islands 00820 • (340) 718-2980