Consent to Receive 2025 W-2 Statement Electronically
To comply with IRS regulations, you must complete this form to authorize the digital delivery of your 2025 W-2.Please read carefully before signing:By selecting this option, you agree to receive your W-2 Statement via email. Wicked Cantina will email only ONE copy of your W-2. It is the employee's sole responsibility to ensure their email address and personal information are up to date in our system. Wicked Cantina is not responsible for undelivered documents due to incorrect or outdated contact information.Data Security Disclaimer:By requesting email delivery, you acknowledge that Wicked Cantina is not responsible for any data loss, interception, or security breaches that may occur during electronic transmission.
Location of Employment
*
Please Select
Bradenton Beach, FL
Sarasota, FL
St. Petersburg, FL
Name
*
First Name
Last Name
Date of Birth
*
.
Month
.
Day
Year
Last Four of Social Security Number
*
Email
*
Confirmation Email
example@example.com
Mobile Number
*
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Signature
*
Date of Signature
*
*
Submit Request
Submit Request
Should be Empty: