W-2 Email Request (Newest)

C.F.S.I Employment Services Century Leasing Century Temporary Services
First and Last Name*
Last 4 of SSN*
Year of W2 *
I give permission to CFSI/Century Leasing/Century Temporary Services to send my W-2 form to me through email. Please, send it to the following email address:
Email Address*
example@example.com
Please list a valid contact number we can reach you at in case of any issues with the email address you provided.
Phone Number*
Employee Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: