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It facilitates the replacement of lost or missing IRS Form W-2 or 1099-MISC documents for employees and contractors. The form requires essential identifying details including consumer and provider names, identification numbers, and contact information. Users must specify the reason for the request, provide current mailing address updates, and include a formal certification statement under penalty of perjury. Processing instructions specify that documents are provided via mail only, strictly prohibiting fax or email transmission of sensitive tax documents, and emphasize that incomplete forms will lead to delays. The template ensures secure record management and regulatory compliance for financial document issuance within the state-funded CDC+ program framework.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/2025-cdc-duplicate-w-2-and-1099-request-form-official-application/303569/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/2025-cdc-duplicate-w-2-and-1099-request-form-official-application/303569.png","ImageObject",442,249,{"name":88,"@type":89},"Cart","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-03","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"How can I receive my requested W-2 or 1099 forms?","Question",{"text":108,"@type":109},"Please note that CDC+ cannot fax or email your W2s and/or 1099s; they will be mailed to the address provided on the form.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What information is required to process the request?",{"text":113,"@type":109},"You must provide the Consumer Name and Number, Provider Name and Number, Provider contact phone, the specific reason for the request, and a completed address section.",{"name":115,"@type":106,"acceptedAnswer":116},"What must be submitted if the address is incorrect?",{"text":117,"@type":109},"If the provider is a current provider and you are requesting a change of address, a new 2026 W-4 or W-9 form must be included with this request.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},303569,1791020607,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},18829141979164,"https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","2025 CDC+ Duplicate W-2/1099 Request Form  \nDate of Request:    \nRequest For IRS Form W-2 or 1099  \n2025 Wage and Tax Statement (Form W-2) for the following employee  \n2025 Miscellaneous (Self-Employment) Income (Form 1099-MISC) for the following contractor Personal Information  \n1. Consumer Name:    \n2. Consumer \\#:    \n3. Provider Name:    \n4. Provider \\#:    \n5. Provider Contact Phone:    \nReason requested  \nThe Form W-2/1099 is requested for the following reason:  \nNever Received  \nMisplaced or Destroyed  \nIncorrect Address (see below – If provider is a current provider, a new 2026 W-4 OR W-9 MUST be present.)  \nSection below must be completed for processing, if not completed it will delay processing of your  request.  \nAddress:    \nCity & State:   Zip Code:    \n(To Be Completed by CDC+ Finance) Date New W4/I-9 Sent to CDC+ Finance   \nCertification Statement  \nUnder penalty of perjury, I confirm that the above information is true and correct.  \nSigned:   Print Name:    \nDate:    \nFinance Authorization Name & Date    \n**** Please note CDC+ can’t fax or email your W2s and/or 1099s.  \n***Please FAX form back to 850-487-1903 or email to[cdc.reimbursement@apdcares.org](cdc.reimbursement@apdcares.org)***  \nFINAL 2/5/2026","cbCaitvRpbGnINJx","https://ap.wps.com/l/cbCaitvRpbGnINJx","pdf",142142,"English","# Personal Information\n## Reason for Request\n# Certification Statement","[{\"question\":\"How can I receive my requested W-2 or 1099 forms?\",\"answer\":\"Please note that CDC+ cannot fax or email your W2s and/or 1099s; they will be mailed to the address provided on the form.\"},{\"question\":\"What information is required to process the request?\",\"answer\":\"You must provide the Consumer Name and Number, Provider Name and Number, Provider contact phone, the specific reason for the request, and a completed address section.\"},{\"question\":\"What must be submitted if the address is incorrect?\",\"answer\":\"If the provider is a current provider and you are requesting a change of address, a new 2026 W-4 or W-9 form must be included with this request.\"}]","2025 CDC+ Duplicate W-2 and 1099 Request Form - Official Application | PDF",1789805333]