New W-2 Request

W-2 U.S. Mail / Email Request

Name

Please use proper names only

Address

Phone

Please enter a mobile number

Email

Verify you email

Enter the last 4 digits of your social security number

This is used to verify your information.

Are you a current employee?

Yes

No

Preffered format to receive W-2

U.S. Mail

Email

Terms of Service

By sending this form your are authorzing Randy James Inc. to send out your W-2 via U.S. Mail or Email. Receipient is aware of possibility of sensitive information being intercepted.

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