TAX INFORMATION REQUEST

To request a copy of your Form W-2, 1095-C, or 1099 from a prior year, please submit your request via USPS (address below) or by completing the following form:

First Name

Last Name

Phone Number

Email

Mailing Address

Other Information

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All requested forms will be sent out within 30 days via USPS, or if requested, may be emailed or picked up in person at:

Kitsap 911 Public Authority
Attention: Finance Manager
911 Carver St.
Bremerton, WA
98312

For additional assistance, please contact Steve Rogers (Finance Manager) at accounting@kitsap911.org or 360-307-5802.