E-Mail address:
Type of information required or desired: Personal Information:
Type of information on file: Date of birth:
DOB: SSN or SSN (if applicable):
Name of parent(s) who are NOT employees/officers (if applicable):
Name of parent(s) who are employees/officers (if applicable):
Type of information on file: First. Name of organization:
Title:
Type of information on file:
Type of information listed on pay stub: Date of birth:
DOB: SSN or SSN (if applicable):
Note: When we obtain information from your pay stub, it will go directly to a third party payroll processor. Please be aware of the implications of having multiple pay stubs from the same employer.
Type of information in Pay Stub:
Type of information on file: ID number:
Type of information on file: ?
Type of information on file: date of birth:
DOB: SSN or SSN (if applicable):
Please contact your local Social Security Administration (SSA) offices about your SSN:
Please contact your local SSA offices about the FICA tax deductions we will claim on your tax return:
Please note: If your Social Security number or SSN was provided by the Department of Defense to federal agencies upon discharge of your military service, and you need information from your pay stub, then you can contact your local Federal Financial Services Ombudsman (FW SOP) for assistance. If the FW SOP has not responded within 60 days, the FW SOP can help you obtain information directly from your employer.
W-2G — W2G (for employers), W2G (for employees). Full Name:
Last.
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If additional information not listed on this form is needed, please contact the
employer. PAYROLL SECTION - Employee Personal Information. Full Name:
Last.
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