Payroll Records Request
- SANDBOX
REQUESTER INFORMATION
Relationship with University:
Employee/Department
Former Employee
Retired
Beneficiary
Vendor
Other
Specify Other:
Please select...
Spouse
Domestic Partner
Guardian
Sibling
Child/Step Child
Public Agency
Other
Requester Campus
UCLA
UCOP
UCM
Requester University ID (UCLA)
Requester EmplID (UC Path ID)
Where can I find the ID?
Requester Last Name
Requester First Name
Middle Initial
Requester Previously Used Name(s)
Requester Email
Requester Phone
Describe your relationship for whom you are requesting the records?
Vendor/Affiliate Name
.
RECORDS REQUESTED
I am requesting Records for
Myself
Someone else
I am requesting records for:
University ID (UCLA)
EmplID (UC Path ID)
Where can I find the ID?
Last Name
First Name
Middle Initial
Previously Used Name(s)
Email
Phone
Start Year
End Year
Type of Record
Please select...
W2 forms
Records of Earnings
PAF (Personnel Action Forms)
Description
Delivery Method
Please select...
Mail
Email
Fax
Pick up
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