HR Request
Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Work email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select Category
*
Please Select
Document Upload
Benefits
Employment Verification
Complaint Against Management / Amazonian
Payroll
Request call back
General Inquiry
Scheduling
Permanent Schedule Change Request
New-Hire Inquiry
Document Upload
Document name
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of
Benefits
Select Benefit
*
Please Select
Health Insurance
401k Retirement Plan
Education Tuition Reimbursment
Additional Information
*
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of
Employment Verification
Additional Information
*
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of
W2 Request
Best email to receive W2 PDF
example@example.com
Date
-
Month
-
Day
Year
Date
Last 4 of Social
W2 Tax year requested
Request for call back
Reason for call back request
*
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of
Complaint Against Management / Employee / Amazonian
Please provide as much information as possible
*
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of
Payroll
Additional Information
*
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of
General Inquiry
Additional Information
*
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of
Scheduling
Additional Information
*
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of
Permanent Schedule Change Request
Please pick from current available Shifts?
*
Please Select
Sunday / Monday / Thursday / Friday
Sunday / Wednesday / Thursday / Friday
Monday / Thursday / Friday / Saturday
Wednesday / Thursday / Friday / Saturday
Sunday / Thursday / Friday / Saturday
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of
New Hire Inquiry
Additional Information
*
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Signature
Submit
Should be Empty: