Chesapeake Public Schools
Please print or type
Requesting W-2 for Tax Year(s): Employee ID Number
Employee Name (Please Print-First, MI, Last) Employee Social Security Number
- -
Street Apt. #
Please check one:
Please mail the W-2 to my address above.
Please allow up to 5 business days after the request has been received for the W-2 to be reissued.
Also allow additional days if mailing of the W-2 has been requested.
Signature of Employee ___________________________________________________________________________
I will pick up the W-2 from the Accounting Department. An Accounting Department
representative will call when the W-2 is ready for pick up.
City State Zip Code
5. Call the Accounting Department at (757) 547-0465 for more information.
1. All information must be completed, including the address, and the form must be signed. Incomplete forms
will not be processed and will be returned. Forms may be faxed or mailed.
2. Fax completed form to (757) 547-0929 or mail completed form to the Accounting Department,
312 Cedar Road, Chesapeake, VA 23322.
3. W-2's will be reissued for the most recent tax year and up to 4 years prior to the current tax year.
To obtain a W-2 reissue for any year prior to this period, complete Internal Revenue Service (IRS) form 4506
and mail it directly to the IRS per the instructions on the form. The IRS form is available by calling
1-800-829-3676 or at
4. If someone other than yourself will be picking up your W-2 reissue, that individual must bring written
authorization from you. Valid photo identification must be provided for anyone picking up W-2's.
Home/Cell Phone No. Work Phone No.