Request for Duplicate/Corrected W-2
All sections of this form must be properly completed or it will be returned to you, unprocessed.
First Name:
(as it appears on W-2 form)
Last Name:
(as it appears on W-2 form)
Employee ID:
(from pay stub)
- OR -
Last 4 SS #:
Street Address:
City, State, Zip Code:
Year:
Telephone:
E-Mail Address:
Confirm E-Mail Address:
Adecco Group company for which you worked:
Ajilon Legal
Ajilon FO
Ajilon IT
Accounting Principals
Special Counsel
MPS
Soliant/Sunbelt
Modis
Beeline
Idea
Other
Complete if you are requesting one of the following:
Duplicate W-2
Corrected W-2
Explain:
Type of Employment:
Colleague
Associate
Traveller
Choose Delivery Preference:
U.S. Mail (sent from Florida)
E-Mail
Check:
