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Get USCG CG-2016 2015-2024

If we can t read your writing we will not be able process your request. Reset CG-2016 03/15 Click to Submit Request by Email. DEPARTMENT OF HOMELAND SECURITY U*S* Coast Guard REQUEST FOR DUPLICATE OR REPLACEMENT IRS FORM W-2 1. EMPLOYEE ID 2. TODAY S DATE 3. LAST NAME 4. FIRST NAME 6. ADDRESS Street RR Box Apt etc* 7. EMAIL ADDRESS 8. CITY 9. STATE/COUNTRY 5. MI 10. ZIP/POSTAL CODE 11. DAYTIME PHONE You will receive your W2 in the mail within 10 working days. 12. MEMBER STATUS Select one Active Duty Reserve Separated/Deceased 13. TAX YEAR Desired for PRIVACY ACT STATEMENT IAW 5 USC Sec* 522a e 3 the following W-2 e*g* 2014 2013 is provided when supplying personal information to the U*S* Coast etc* Guard Authority 31 USC Section 3332. Retired Principal Purpose Used to identify member s pay account and provide distribution instructions for annual employee s wage and earnings statement. Routine Uses Same. Disclosure Disclosure of this information is voluntary but without NOTE If you need a 1099R form from our Retired pay section please call 1-800-772-8724 for assistance. disclosure member may not receive a replacement IRS Form W-2. 14. SIGNATURE DO NOT MAIL WITHOUT A SIGNATURE If submitting via CG Workstation a digital signature will be accepted 15. Is the member deceased Complete only if the person signing in block 14 is not the same as person identified in blocks 1 through 5 16. Your Printed Name First Middle Initial Last Required only if block 15 is YES Yes 17. Relationship to deceased Required only if block 15 is YES Complete the form and email the SIGNED completed LEGIBLE form to ppc-dg-customercare uscg. mil* Instructions If unable to email please mail to Commanding Officer SES-AA Pay Personnel Center 444 SE Quincy St* Topeka KS 66683-3591 NOTE If filling out by hand please print legibly. DEPARTMENT OF HOMELAND SECURITY U*S* Coast Guard REQUEST FOR DUPLICATE OR REPLACEMENT IRS FORM W-2 1. EMPLOYEE ID 2. TODAY S DATE 3. LAST NAME 4. FIRST NAME 6. ADDRESS Street RR Box Apt etc* 7. EMAIL ADDRESS 8. EMPLOYEE ID 2. TODAY S DATE 3. LAST NAME 4. FIRST NAME 6. ADDRESS Street RR Box Apt etc* 7. EMAIL ADDRESS 8. CITY 9. STATE/COUNTRY 5. MI 10. ZIP/POSTAL CODE 11. DAYTIME PHONE You will receive your W2 in the mail within 10 working days. CITY 9. STATE/COUNTRY 5. MI 10. ZIP/POSTAL CODE 11. DAYTIME PHONE You will receive your W2 in the mail within 10 working days. 12. MEMBER STATUS Select one Active Duty Reserve Separated/Deceased 13. TAX YEAR Desired for PRIVACY ACT STATEMENT IAW 5 USC Sec* 522a e 3 the following W-2 e*g* 2014 2013 is provided when supplying personal information to the U*S* Coast etc* Guard Authority 31 USC Section 3332. 12. MEMBER STATUS Select one Active Duty Reserve Separated/Deceased 13. TAX YEAR Desired for PRIVACY ACT STATEMENT IAW 5 USC Sec* 522a e 3 the following W-2 e*g* 2014 2013 is provided when supplying personal information to the U*S* Coast etc* Guard Authority 31 USC Section 3332. Retired Principal Purpose Used to identify member s pay account and provide distribution instructions for annual employee s wage and earnings statement. .

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