MNSU
Request for Duplicate or Corrected Wage and Tax Statement (W-2) For Calendar Year:___ Please type or print. Employee ID Social Security Number Agency Daytime Phone Number Employee Name (Last, First, Initial) Current Address (Street, City, State, Zip) Former Address (Street, City, State, Zip) Check one: ___ I have lost or not received my W-2 for the year above ___ My W-2 form is not correct. (Enclose incorrect W-2 and explanation of error.) Employee's Signature Date Please submit the completed form to your Human Resources or Payroll Office MorePlease type or print. Employee ID. Social Security Number. Agency. Daytime Phone Number. Employee Name (Last, First, Initial). Current Address (Street, City , ... Less
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