AM ERICAN UNIVERSITY PAY ROLL ACTION REQUEST
2 0 1 5 W -2 / 1 0 4 2 S W A G E & T A X F O R M S
(IRS Form 1098 contact Student Accounts – x3541)
(IRS Form 1099 contact Accounts Payable – x2840)
EMPLOYEE INFORMATION
AU ID:
Date:
First Name:
MI:
Birth Date:
SSN:
Last Name:
I am paid on a:

Monthly

Biweekly
Address:
City:
State:
Requested by
(please check one)
INQUIRY

Phone Call


Zip:
Written

Email
Phone:

Walk-in
DETAILS
W-2

1042s

Reprint of Year(s)

Incorrect SSN

Incorrect Totals
Please explain details of the inquiry below:
IF REPLACEMENT
IS
NEEDED,
SPECIFY METHOD OF FORM DELIVERY

Pick up at Human Resources front desk.

Follow-up phone call request

Mail to the following address:
Street:
City:
State:
Zip:
FOR HR PURPOSES ONLY
Action Taken:
Resolved by:
Payroll Use Only
American University – Payroll Office 01/2016
Date:
RECORD NUMBER:

Other
basis