For items 6 and 8 show only earnings covered by Social Security. Use this step-by-step guideline to fill out the Form ssa quickly and with ideal precision. The advanced tools of the editor will lead you through the editable PDF template. Enter your official identification and contact details. Utilize a check mark to indicate the choice wherever demanded.

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Information on that the requester provides on the form enables us to identify the correct record and process the request through the electronic Statement system. We use this information to verify that the SSN record requested belongs to the person requesting the Statement.

Earnings information We ask requesters to tell us how much they earned last year because these earnings may not yet be posted to their record.

We also ask them to tell us how much they expect to earn this year and the average earnings they expect to have in future years before they stop working. Requesters are cautioned on the form to include only earnings that are covered by Social Security; noncovered earnings will distort the benefit estimate calculations.

We use the earnings information the requesters provide to calculate credits for insured status if the SSN holder is not already insured based on the posted earnings record.

We also use it to calculate benefit estimates. Age requester plans to stop working We will use the age the requester plans to stop working to calculate credits and compute benefit estimates. Requests to send the statement to a third party Generally, we mail an on-request Statement directly to the SSN holder who asked for it. Some SSN holders, however, want their Statements to go to a third party such as their accountant, financial advisor or pension plan agent. We will accommodate these requests by sending the Statement in care of the third-party address.

The date the request form or other correspondence is signed must not be more than 60 days before the date SSA receives it. Requesters who send in an English form will receive an English Social Security Statement in response. A Spanish request form will generally result in a Spanish statement. However, each version of the SSASM-OP1 also contains a check block that the requester can use to ask for the statement in the other language.

Exhibits 1. Items 6 and 8 request earnings information for last year, this year and future years. Item 7 asks when the requester plans to stop working. At the bottom of the last panel of the form is a penalty notice and signature line.

It is sent for completion to requesters whose original request forms cannot be processed because they are damaged, illegible or incomplete. The form inside the envelope is version OP1; the envelope is designated OP2 for differentiation in requesting supplies.

It shows the current format and has an attachment with instructions about size limits, weight of paper and other conditions that the requesting organization must follow to make their printings acceptable.


The Social Security Statement, Form SSA-7005-SM



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