Please complete this
form for each Tax Year requested. For Tax Years prior to 2003, please
download and complete this form in Word format. After completing the form, please mail it to the following address:
State of Connecticut
Office of the State Comptroller
Payroll Services Division
55 Elm St Hartford, CT 06106
Fields marked with an
asterisk (*) are required. Please enter the ZIP Code and telephone
number fields as numbers only (no dashes or parentheses).
You will receive a copy of your request in an email message.
Reissued W2s will be sent back to the agency. Please allow ample time for processing,
especially for years prior to 1990.
This form should be completed by the employee's corresponding agency.
The Payroll Services Division will not process requests entered by the
Calendar years 2011 through the current date are accessible to Agency
Payroll Specialists and no longer require this request process. Any
Calendar year requests for 2011 and forward will be referred back to the
employee's agency payroll office.