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    Section 1: Personal Information: Hrpayroll@siu - Edu

    Uploaded by

    Yagya Raj Joshi
    This document is a consent form for receiving W-2 forms electronically from Southern Illinois University Carbondale. It requests the employee's personal information and payroll details. The employee authorizes the university to provide their W-2 electronically through the HR self-service system between January and October each year rather than a paper form. The consent will remain valid until revoked by the employee or upon termination of employment.

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    © All Rights Reserved
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    Section 1: Personal Information: Hrpayroll@siu - Edu

    Uploaded by

    Yagya Raj Joshi
    15 views1 page
    This document is a consent form for receiving W-2 forms electronically from Southern Illinois University Carbondale. It requests the employee's personal information and payroll details. The employee authorizes the university to provide their W-2 electronically through the HR self-service system between January and October each year rather than a paper form. The consent will remain valid until revoked by the employee or upon termination of employment.

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    Good Stuff

    Original Title

    Hro 2000

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    This document is a consent form for receiving W-2 forms electronically from Southern Illinois University Carbondale. It requests the employee's personal information and payroll details. The employee authorizes the university to provide their W-2 electronically through the HR self-service system between January and October each year rather than a paper form. The consent will remain valid until revoked by the employee or upon termination of employment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    15 views1 page

    Section 1: Personal Information: Hrpayroll@siu - Edu

    Uploaded by

    Yagya Raj Joshi
    This document is a consent form for receiving W-2 forms electronically from Southern Illinois University Carbondale. It requests the employee's personal information and payroll details. The employee authorizes the university to provide their W-2 electronically through the HR self-service system between January and October each year rather than a paper form. The consent will remain valid until revoked by the employee or upon termination of employment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    ELECTRONIC W-2 CONSENT

    SOUTHERN ILLINOIS UNIVERSITY CARBONDALE

    SECTION 1: PERSONAL INFORMATION

    Last Name First Name Middle Initial

    AIS Number Last 4 of SSN SIU Campus ID

    Daytime Phone Number Email Address

    Payroll Type: Monthly Faculty/AP Staff/Grad Asst./UGA Semi-monthly Civil Service

    Bi-weekly Civil Service Bi-weekly Student

    SECTION 2: AUTHORIZATION

    I consent to receive my W-2 form electronically. By consenting to receive your W-2 electronically, you agree
    to use Human Resources Self-Service (HRSS) between January 31 and October 15 of the appropriate year to
    print your W-2 form on-line. You may be required to print and attach your W-2 form to a Federal, State, or
    local income tax return. Your consent will be valid for all subsequent tax years unless revoked by you, upon
    termination, or if this service is not supported in a future tax year. You may revoke your consent and
    receive a paper Form W-2 by contacting Payroll at hrpayroll@siu.edu to receive the Request to Revoke
    Electronic W-2 Consent form and then returning the completed form to Payroll. Updating employee contact
    information is the responsibility of the employee by providing up-to-date names and addresses in HRSS or
    providing a Change of Address Form to Human Resources.

    Employee Signature Date Signed

    Please submit completed and signed form to: Southern Illinois University
    Human Resources
    Miles Hall - MC 6520
    Carbondale, IL 62901-6520
    Fax: 618.453.1353
    hrpayroll@siu.edu

    For Office Use Only:

    Entered by:_____________ Date entered:______________

    hro2000
    Clear Form Print Form
    11/17 Page 1 of 1

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