Fillable NSU Request for Duplicate W?2 Form

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NSU Request for Duplicate W?2 Form

On average this form takes 3 minutes to complete

The NSU Request for Duplicate W?2 Form form is 1 page long and contains:

  • 1 signature
  • 4 check-boxes
  • 8 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Nova Southeastern University

BROWSE NOVA SOUTHEASTERN UNIVERSITY FORMS

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RequestforDuplicateW‐2FormforTax‐Year:________
Please
issueaduplicatecopyoftheWageandTaxStatement(FormW‐2)forthefollowingemployee:
Employeename:_______________________________________NSUID:N___________________
DistributionofForm:
PickUpfromPayroll Office:
Mail Form:
__________________________________________________________
CityStateZipCode
ReasonforRequest: NeverReceived

Lost/Misplaced/Destroyed
SignatureofEmployee:_______________________________________________
ContactNumber/Extension:______________________________________________
*Ifrequestingthattheformbemailed,pleaseprovideacopyofpictureidentification,suchasadriver’s
license(formeremployees)orIDbadge(currentemployees),alongwiththisrequestform.Ifpickingup
theduplicateformW‐2inperson,pleasebepreparedtoshowpictureIDsuchasadriver’slicenseoryour
IDbadge.Allowfivebusinessdaystoprocessyourrequest.
PleasereturnthisformtothePayrollDepartment:
EMAIL:PAYROLL@nova.eduFAX:(954)262‐3997MAIL:NovaSoutheasternUniversity
PayrollDepartment
3301CollegeAvenue
FtLauderdale,FL33314
For Payroll Department Use Only:
Date request received: ______________________ Date form mailed to employee: ___________________
Or Date picked up by employee: ______________
Signature of employee if picked up in person: ________________________________________________
PAYROLL IS LOCATED ON THE EAST CAMPUS AT
3100 SW 9TH AVE. (NEAR FTLAUDERDALEAIRPORT)
_________________________________________________________
Street Address
*If a request is made after April 15 or for a previous year, a $6.00 fee will be charged. Please submit
$6.00 in check or money order only.
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NSU Request for Duplicate W2 Form

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Completed 25 December 2019

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