Request for Duplicate W2

Looking for 2009 W2s? Visit the W2 Online Access Instructions Page!

For all other years, please use the form below to request duplicate copies of your W2.

If you have questions, please call our Home Office Front Desk at 503.375.9016.

Worksite/Facility	Tax Year Requested	Last Four Digits of SSN XXX-XX-
Last Name	First Name		Middle Initial
Street Address	Apt #
Address Line 2
City	State	ZIP Code

I hereby authorize Senenet, Inc. to release a copy of my W-2 form:

	By mail:	(to address above)
	By fax to:
	By email to:

Digital Signature: (Please Type Full Name)

Please Note: It will take approximately two weeks to process your request. You will be notified if we are unable to accommodate your request for any reason.