Data Dispute Form

Personal Info

Dispute Info

Upload Documents
(Optional)

Step 1 of 2

EMPLOYEE DATA DISPUTE

To dispute information on your Employment Data Report (EDR), simply complete and submit the necessary information. Please note the dispute process may take up to 30 days for completion.

For questions, please contact The Work Number Employee Service Center at 1-866-222-5880 or 1-800-424-0253 for TTY-hearing impaired assistance Monday through Friday, from 9:00 a.m. to 8:00 p.m. ET.

Please note asterisks (*) indicate fields required for submission.

Social Security Number*

First Name*

Last Name*

Suffix

Street Address (Residential)*

City*

State*

Zip Code*

Phone Number*

Email Address*

What is your preferred method of contact?*

Phone

Personal Info

Dispute Info

Upload Documents
(Optional)

Step 2 of 2

Disputed Information

Please enter your Employer Name or Employer Code.*

Please select your main cause for completing this Employee Data Dispute. Only one option may be selected.*

Please enter all of the information you would like to dispute in the optional fields below.

Employment Information

Original Hire Date (MM/DD/YYYY)

Most Recent Hire Date (MM/DD/YYYY)

Term Date (MM/DD/YYYY)

Employment Status

Job Title

Total Time With Employer

Pay Information

Rate of Pay

Pay Period Details (i.e., pay date, hours worked, gross, net earnings)

Average Hours Per Pay Period

Personal Information

Married and/or Maiden Names

Legally Changed Name

Aliases

Please enter any additional comments regarding the information listed above.

If you have additional information you would like to dispute regarding pay, please check the box below. Please note fields marked with asterisks are required.

I have additional information to add.

Back to Step 1

Personal Info

Dispute Info

Upload Documents
(Optional)

Step 3 of 3

PROVIDE YOUR DOCUMENT(S)

To fulfill your request, we need to confirm your proof of identity and/or your address. You can also provide documents that support your dispute claim.

Choose from the following options to provide your documents.

Best Way

Upload Your Documents

The maximum file size is 5MB. Upload up to 2 files in a single selection. You may upload any of the following document types:

PDF, DOC, DOCX, JPG, JPEG

Drag and drop file here

or Browse Files

OTHER OPTIONS

Email Us Your Documents

You can also send your documents through a secure email. Once you submit this dispute form, you will receive a secure email from our team. Please reply to that email with a document that confirms your identity and a document that confirms your address in line with the requirements below. You can also include any acceptable supporting documentation.

If you prefer to mail us your documents, please exit this web form. Instead, print and mail us a hard copy of the Employee Data Dispute form with copies of your documents.

Acceptable Documents

Proof of Identity

Provide a copy of one of the following. Must include current/legal name.

Current driver's license
State or government ID card
Social security card
Military ID card
Current, USA-issued passport
W-2 or 1099 Form from the most recent year

Proof of Address

Provide a copy of one of the following. The document must include your current mailing address and be issued within the past 60 days.

Utility Bill (phone, water, gas, electric, trash or sewer, etc.)
Paystub
Housing Rental Agreement or Mortgage document in your name
W-2 or 1099 Form for the most recent year

Acceptable Supporting Documentation

W-2 or other company-issued documentation
Offer letter on company letterhead
Paystub within the past 60 days
IRS Tax Transcripts