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Get Replacement Request Form Additional Copies Of W-2

_____________ City: ___________________ State: _________ Zip: __________ Phone: __________________________________ Year of W-2 Requesting: ____________________ Number of Copies Needed: __________________ E-mail Address: _____________________________ Would you like your W-2 sent to your home address or to your e-mail address? ___________________________________________________________________________ There is a $5.00 service charge per copy requested. WE ARE NOT ABLE TO ACCEPT CREDIT OR DEBIT .

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