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Get CA STD 436 2019

Roll Services Division ATTN: Duplicate W2 P.O. Box 942850 Sacramento, CA 94250-5878 INITIALS LEFT MSG DATE CALLED SPOKE WITH DATE MAILED INITIALS POIII INITIALS DATE PICKED UP ASB INITIALS EMPLOYEE OR AUTHORIZED DESIGNEE SIGNATURE PLEASE PRINT OR TYPE SECTION A - EMPLOYEE INFORMATION SOCIAL SECURITY NUMBER FIRST NAME MIDDLE INITIAL LAST NAME PHONE NUMBER SECTION B - TAX YEAR(S) REQUESTED (only four (4) prior tax years are available) SCO USE ONLY SECTION C - COMPLETE ONLY IF YOU WOU.

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