DEPARTMENT OF HUMAN Shuster Hall, Room 230 Phone: 718-960-8181 RESOURCES 250 Bedford Park Blvd West, Fax: 718-960-1191 Bronx, NY 10468 www.lehman.edu Employee W2 Reprint Inquiry (Date) (Name) Name: ___________________________ Date: ______________________________ Title: ____ Full Time Faculty _____ Adjunct Faculty _____HEO Series (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked ____ Full Time Classified _____ Part Time Classified (Please indicate the year of the W2 reprint) (checkbox) Unchecked (checkbox) Unchecked Please indicate the year of the W2 reprint: ________ Please provide your new address (if applicable): (Please provide your new address (if applicable [1]) (Please provide your new address (if applicable [2]) (Please provide your new address (if applicable [3]) Please provide your contact information: (Email) (Telephone) Telephone: _______________________ Email: ______________________________ H.R. Response Date: ___________________________ *Please anticipate 3 – 5 business days for processing.