HomeMy WebLinkAboutW2 Email Consent FormCity of Iowa City
Form W-2 Consent for E-Mail Delivery
Return completed form to:
City of Iowa City
Payroll
410 E Washington St
Iowa City, IA 52240
Telephone: (319) 356-5084 Fax: (319) 887-6215
E-mail: samara-hayek@iowa-city.org
Consent to receive Form W-2 as an attachment to an e-mail ( no printed copy)
Consent to receive Form W2 on ESS (no printed copy) printing can be done in ESS
Change of Consent – “I no longer wish to receive my W-2 electronically”
EMAIL DELIVERY ONLY PLEASE PRINT CLEARLY
Employee Name:_________________________________ Employee ID # ___________
Your W-2 will be sent to your Primary E-Mail Address as listed in your Employee Master record.
You can change this on the Employee Self Service website at any time.
Primary E-Mail Address _____________________________________________________
Note: This W-2 form will be a Portable Document Format (PDF) that requires Adobe Acrobat
Reader. If you do not already have it installed, you may download a copy free from the following
address, http://www.adobe.com/products/acrobat/readstep2.html
IMPORTANT DISCLOSURE INFORMATION
If this form is not signed and returned to the payroll department for consent to receive a W-2 via e-
mail or through ESS, the employee will receive a paper Form W-2
The only requirement to open the PDF attachment will be a copy of Adobe Acrobat Reader. Your
e-mail service provider must accept password protected attachments.
This consent will remain in effect until the employee signs another form and checks the “Change
of Consent” box that will release City of Iowa City to return to sending the employee their Form
W-2 as a printed copy. This change of consent will only apply to future Form W-2 forms and does
not apply to the previously issued Forms W-2
At any time, an employee may request an official printed Form W-2 from the City of Iowa City
payroll department located in Accounting. That request will not change the consent to receive
future Form W2 forms electronically by e-mail or ESS.
This consent remains in effect after a person is no longer an employee of City of Iowa City. All
former employees of the city have the ability to update their e-mail information using the
Employee Self Service (ESS) web site. All former employees remain active on the ESS website to
be able to view pay history, W-2s and leave history.
City MSS site is available at https://citymss.iowa-city.org/MSS/default.aspx
Signature________________________________Date_______________________________
For office use: Received by: ___________________________ Date Received ____________