Fillable SAMFORD UNIVERSITY Payroll Office 800 Lakeshore Drive Birmingham, (Samford University)

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SAMFORD UNIVERSITY Payroll Office 800 Lakeshore Drive Birmingham, (Samford University)

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SAMFORD UNIVERSITY
Payroll Office
800 Lakeshore Drive
Birmingham, AL 35229
Email: payroll@samford.edu
Fax: (205) 726-4027
W-2 REQUEST
(Please print or type)
Date of Request
Please reissue a Form W-2 for the following employee for the calendar year(s):
EMPLOYEE NAME:
SU ID NUMBER:
TELEPHONE NUMBER:
EMPLOYEE CURRENT MAILING ADDRESS: Change permanent mailing address
(can not be changed to a SU Box)
Street Address:
City: State: Zip Code:
PLEASE INDICATE HOW YOU WOULD LIKE TO RECEIVE YOUR W2:
Mail home
Campus address:
Fax to:
Pick up in Payroll Office
The duplicate W-2 is requested for the following reason:
Original never received
Original misplaced or destroyed
Other (explain)
Signature of Employee
_
FOR PAYROLL OFFICE USE ONLY:
Date request received: Original W-2 remailed:
Processed by: Duplicate W-2 mailed:
Revised: 03/20
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SAMFORD UNIVERSITY Payroll Office 800 Lakeshore Drive Birmingham, (Samford University)

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Completed 26 August 2020

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