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Get NY 1095C/W-2 Duplicate Request And Information Correction Form 2019

Ion Form DUPLICATE REQUEST Please Check One: Tax year(s)*: 1095C 2019 2017 W-2 2016 2018 2015 2017 20186 2017 2015 other(s): ot CORRECTION REQUEST Tax year(s): SSN# or EMPL ID 2019 2017 Last Name First Name Address: Apt: City: State Zip Contact Phone# Briefly describe error: (Required for W-2 correction only) NOTE: Please verify your address. Address corrections can be updated by logging into NY C.Gov/ESS or by contacting HR Connect.

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