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Fill Out Your Ssa 7050 F4 Form

Form SSA-7050-F4 is a request for Social Security earnings information. This form allows individuals to obtain detailed earnings data, which can include employment history and even yearly totals, based on their specific needs. If you need to fill out this form, please click the button below.

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Article Structure

The Form SSA-7050-F4 serves as a vital tool for individuals seeking Social Security earnings information. This form allows users to request both certified and non-certified detailed earnings records covering periods of employment or self-employment. Specifically, it provides detailed itemized statements that include the names and addresses of employers, as well as yearly totals of earnings that may exclude these details. Users interested in obtaining yearly earnings totals are advised that such information can be accessed free of charge through the Social Security Administration's website, provided they do not need certification. Proper completion of this form is essential, as it must capture specific details like Social Security numbers, the individual's name, and the reason for the request, along with any necessary documentation. It is critical to submit the form to the SSA within 120 days of signing it. Additionally, the form outlines relevant fees associated with the request, including charges for certification. Privacy considerations are also highlighted, indicating how personal information may be used and shared in compliance with federal laws. Understanding these aspects of the SSA-7050-F4 is essential for anyone looking to navigate the process smoothly.

Ssa 7050 F4 Example

Form SSA-7050-F4 (02-2021)
Discontinue Prior Editions	Page 1 of 4
Social Security Administration	OMB No. 0960-0525

REQUEST FOR SOCIAL SECURITY EARNING INFORMATION

*Use This Form If You Need

1.Certified/Non-Certified Detailed Earnings Information Includes periods of employment or self-employment and the names and addresses of employers.

2.Certified Yearly Totals of Earnings

Includes total earnings for each year but does not include the names and addresses of employers.

DO NOT USE THIS FORM TO REQUEST

YEARLY EARNINGS TOTALS

Yearly earnings totals are free to the public

if you do not require certification.

To obtain FREE yearly totals of earnings, visit our website at www.ssa.gov/myaccount.

Privacy Act Statement

Collection and Use of Personal Information

Section 205 of the Social Security Act, as amended, allows us to collect this information. In addition, the Budget and Accounting Act of 1950 and Debt Collection Act of 1982 authorize us to collect credit card information, if you choose to pay for the earnings information you have requested with a credit card. Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent us from processing your request.

We will use the information to identify your records, process your request, and send the earnings information you request. We may also share the information for the following purposes, called routine uses:

1.To the Internal Revenue Service (IRS) for auditing SSA's compliance with the safeguard provisions of the Internal Revenue Code of 1986, as amended.

2.To contractors and other Federal agencies, as necessary, for the purpose of, assisting the Social Security Administration (SSA) in the efficient administration of its programs.

3.To banks enrolled in the Treasury credit card network to collect a payment or debt when the individual has given his/her credit card number for this purpose.

In addition, we may share this information in accordance with the Privacy Act and other Federal laws. For example, where authorized, we may use and disclose this information in computer matching programs, in which our records are compared with other records to establish or verify a person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent debts under these programs.

A list of additional routine uses is available in our Privacy Act System of Records Notices (SORNs) 60-0059, entitled Earnings Recording and Self-Employment Income System, 60-0090, entitled Master Beneficiary Record, 60-0224, entitled SSA-Initiated Personal Earnings and Benefit Estimate Statement, and 60-0231, entitled Financial Transactions of SSA Accounting and Finance Offices. Additional information and a full listing of all our SORNs are available on our website at www.socialsecurity.gov/foia/bluebook.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 11 minutes to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401.

Form SSA-7050-F4 (02-2021)

Page 2 of 4

REQUEST FOR SOCIAL SECURITY EARNING INFORMATION

1.Provide your name as it appears on your most recent Social Security card or the name of the individual whose earnings you are requesting.

First Name:

Last Name:

Social Security Number (SSN)

Date of Birth:

Middle Initial:

One SSN per request

Date of Death:

Other Name(s) Used

Maiden Name

2.What kind of earnings information do you need? (Choose ONE of the following types of earnings or SSA must return this request.)

Itemized Statement of Earnings $92.00

(Includes the names and addresses of employers)

If you check this box, tell us why you need this information below.

Year(s) Requested:					to
Year(s) Requested:					to

Check this box if you want the earnings information CERTIFIED for an additional $30.00 fee.

Certified Yearly Totals of Earnings $30.00

(Does not include the names and addresses of employers)Yearly earnings totals are FREE to the public if you do not require certification. To obtain FREE yearly totals of earnings, visit our website at www.ssa.gov/myaccount.

Year(s) Requested:

3.If you would like this information sent to someone else, please fill in the information below. I authorize the Social Security Administration to release the earnings information to:

Name

Address		State

City	ZIP Code

4.I am the individual to whom the record pertains (or a person authorized to sign on behalf of that individual).

I declare under penalty of perjury that I have examined all the information on this form, and on any accompanying statements or forms, and it is true and correct to the best of my knowledge.

Signature AND Printed Name of Individual or Legal Guardian	SSA must receive this form within 120 days
Signature AND Printed Name of Individual or Legal Guardian	from the date signed
	Date

Relationship (if applicable, you must attach proof)		Daytime Phone:

Address

State

City		ZIP Code

Witnesses must sign this form ONLY if the above signature is by marked (X). If signed		by mark (X), two witnesses to the
signing who know the signee must sign below and provide their full addresses. Please print the signee's name next to the
mark (X) on the signature line above.
1. Signature of Witness	2. Signature of Witness

Address (Number and Street, City, State and ZIP Code)	Address (Number and Street, City, State and ZIP Code)

Form SSA-7050-F4 (02-2021)

Page 3 of 4

REQUEST FOR SOCIAL SECURITY EARNING INFORMATION

INFORMATION ABOUT YOUR REQUEST

You may use this form to request earnings information for one ONE Social Security Number (SSN)

How do I get my earnings statement?

You must complete the attached form. Tell us the specific years of earnings you want, type of earnings record, and provide your mailing address. The itemized statement of earnings will be mailed to ONE address, therefore, if you want the statement sent to someone other than yourself, provide their address in section 3. Mail the completed form to SSA within 120 days of signature. If you sign with an "X", your mark must be witnessed by two impartial persons who must provide their name and address in the spaces provided. Select ONE type of earnings statement and include the appropriate fee.

1. Certified/Non-Certified Itemized Statement of Earnings

This statement includes years of self-employment or employment and the names and addresses of employers.

2. Certified Yearly Totals of Earnings

This statement includes the total earnings for each year requested but does not include the names and addresses of employers.

If you require one of each type of earnings statement, you must complete two separate forms. Mail each form to SSA with one form of payment attached to each request.

How do I get someone else's earnings

statement?

You may get someone else's earnings information if you meet one of the following criteria, attach the necessary documents to show your entitlement to the earnings information and include the appropriate fee.

1. Someone Else's Earnings

The natural or adoptive parent or legal guardian of a minor child, or the legal guardian of a legally declared incompetent individual, may obtain earnings information if acting in the best interest of the minor child or incompetent individual. You must include proof of your relationship to the individual with your request. The proof may include a birth certificate, court order, adoption decree, or other legally binding document.

2. A Deceased Person's Earnings

You can request earnings information from the record of a deceased person if you are:

• The legal representative of the estate;

• A survivor (that is, the spouse, parent, child, divorced spouse of divorced parent); or

• An individual with a material interest (e.g., financial) who is an heir at law, next of kin, beneficiary under the will or donee of property of the decedent.

You must include proof of death and proof of your relationship to the deceased with your request.

Is There A Fee For Earnings Information?

Yes. We charge a $92.00 fee for providing information for purposes unrelated to the administration of our programs.

1.Certified or Non-Certified Itemized Statement of Earnings

In most instances, individuals request Itemized Statements of Earnings for purposes unrelated to our programs such as a private pension plan or personal injury suit. Bulk submitters may email OCO.Pension.Fund@ssa.gov for an alternate method of obtaining itemized earnings information.

We will certify the itemized earnings information for an additional $30.00 fee. Certification is usually not necessary unless you are specifically requested to obtain a certified earnings record.

Sometimes, there is no charge for itemized earnings information. If you have reason to believe your earnings are not correct (for example, you have previously received earnings information from us and it does not agree with your records), we will supply you with more detail for the year(s) in question. Be sure to show the year(s) involved on the request form and explain why you need the information. If you do not tell us why you need the information, we will charge a fee.

2. Certified Yearly Totals of Earnings

We charge $30.00 to certify yearly totals of earnings. However, if you do not want or need certification, you may obtain yearly totals FREE of charge at www.ssa.gov/myaccount. Certification is usually not necessary unless you are advised specifically to obtain a certified earnings record.

Method of Payment

This Fee Is Not Refundable. DO NOT SEND CASH.

You may pay by credit card, check or money order.

• Credit Card Instructions

Complete the credit card section on page 4 and return it with your request form.

• Check or Money Order Instructions

Enclose one check or money order per request form payable to the Social Security Administration and write the Social Security number in the memo.

How long will it take SSA to process my request?

Please allow SSA 120 days to process this request. After 120 days, you may contact 1-800-772-1213 to leave an inquiry regarding your request.

Form SSA-7050-F4 (02-2021)

Page 4 of 4

REQUEST FOR SOCIAL SECURITY EARNING INFORMATION

·Where do I send my complete request?

Mail the completed form, supporting documentation,	If using private contractor such as FedEx mail form,
and applicable fee to:	supporting documentation, and application fee to:
Social Security Administration	Social Security Administration
P.O. Box 33011	P.O. Box 33011
Baltimore, Maryland 21290-33011	Baltimore, Maryland 21290-33011

·How much do I have to pay for an Itemized Statement of Earnings?

Non-Certified Itemized Statement of Earnings	Certified Itemized Statement of Earnings
$92.00	$122.00

·How much do I have to pay for Certified Yearly Totals of Earnings?

Certified yearly totals of earnings cost $30.00. You may obtain non-certified yearly totals FREE of charge at www.ssa.gov/myaccount. Certification is usually not necessary unless you are specifically asked to obtain a certified earnings record.

YOU CAN MAKE YOUR PAYMENT BY CREDIT CARD

As a convenience, we offer you the option to make your payment by credit card. However, regular credit card rules will

apply. You also pay by check or money order. Make check payable to Social Security Administration.

CHECK ONE

Visa

American Express

MasterCard

Discover

Credit Card Holder's Name

(Enter the name from the credit card)

First Name, Middle Initial, Last Name

Credit Card Holder's Address

Number & Street

City, State, & ZIP Code

Daytime Telephone Number

Area Code

Credit Card Number

Credit Card Expiration Date

(MM/YY)

Amount Charged

See above to select the correct fee for your request.

Applicable fees are $30.00, $92.00, or $122.00.

SSA will return forms without the appropriate fee.

Credit Card Holder's Signature

Date

Authorization

DO NOT WRITE IN THIS SPACE

Name

Date

OFFICE USE ONLY

Remittance Control #

Get Ssa 7050 F4 PDF Form

Form Characteristics

Fact Name	Details
Form Title	Request for Social Security Earning Information (SSA-7050-F4)
Publication Date	February 2021 (02-2021)
Usage Purpose	This form is used to request detailed earnings information from the Social Security Administration.
Types of Information	Requests can be for itemized earnings or certified yearly totals.
Fees for Reports	Itemized Statement costs $92. A certified version costs $122.
Certification Fee	An additional fee of $30 is charged for certified earnings totals.
Processing Time	SSA typically takes up to 120 days to process requests.
Privacy Act Compliance	The form is governed by Section 205 of the Social Security Act and the Privacy Act.
Eligibility for Other Individuals	Requests for another person’s earnings require proof of relationship or legal authority.
Where to Send	The completed form should be mailed to SSA at P.O. Box 33011, Baltimore, Maryland 21290-33011.

Guidelines on Utilizing Ssa 7050 F4

After completing the SSA-7050 F4 form, you should mail it to the Social Security Administration (SSA) along with any required fees and supporting documents. Ensure the form is sent within 120 days of your signature to avoid delays. If your signature is marked (X), two witnesses must sign the form to validate it.

Write your name as it appears on your most recent Social Security card. Include your first name, last name, middle initial, Social Security Number (SSN), and date of birth.
Select the type of earnings information you need. Choose either an itemized statement of earnings for $92.00 or certified yearly totals for $30.00. If you select the itemized statement, provide the years you are requesting.
Complete section 3 if you want the information sent to someone else. Include the name and address of that individual.
Declare your identity as the individual to whom the record pertains or as an authorized person. Sign and print your name, including your daytime phone number, address, and the relationship to the individual if applicable.
If you signed by mark (X), have two witnesses sign the form, providing their names and addresses.
Choose your payment method: credit card, check, or money order. Complete the payment details if paying by credit card or include a check/money order made out to the Social Security Administration.
Mail the completed form, the appropriate fees, and any necessary supporting documents to the SSA.

What You Should Know About This Form

What is the SSA-7050-F4 form used for?

The SSA-7050-F4 form is a request for Social Security earnings information. You can use it to obtain either detailed itemized earnings information or certified yearly totals of earnings. This form is particularly useful if you need this information for purposes such as retirement planning, applying for loans, or verifying your earnings history.

What types of earnings information can I request using this form?

You can request two types of earnings information: an itemized statement of earnings and certified yearly totals of earnings. The itemized statement includes details like names and addresses of employers, while the certified yearly totals show only the total earnings for each year without additional employer information.

Is there a fee to request earnings information?

Yes, there are fees associated with the request. An itemized statement of earnings costs $92.00 if it is non-certified, and $122.00 if certified. Certified yearly totals cost $30.00. If you do not need certification, you can obtain yearly totals for free by visiting www.ssa.gov/myaccount.

Can I request someone else's earnings information?

Yes, you can request earnings information for another person if you meet specific criteria. For example, you may be a parent, legal guardian, or the legal representative of a deceased person's estate. You will need to provide proof of your relationship and the necessary documentation to support your request.

How do I submit the completed form?

Mail the completed form, any supporting documents, and the payment to the Social Security Administration. The address is: Social Security Administration, P.O. Box 33011, Baltimore, Maryland 21290-33011. If using a private delivery service, be sure to send it to the same address.

How will I know when my request has been processed?

Please allow up to 120 days for processing. If you haven’t received your information after that period, you can call 1-800-772-1213 for an inquiry about your request.

What information do I need to provide on the form?

You need to provide your name, Social Security Number, date of birth, and specify the type of earnings information you are requesting. If the request involves another person, you must include proof of your relationship to them, particularly if they are deceased or a minor.

What if I need the document certified?

If you need certification, check the certification box on the form and pay the additional fee. Certification is typically required when the receiving party specifically asks for a certified earnings record.

Can I pay the fee using a credit card?

Yes, you can pay using a credit card. Fill out the credit card section on the form and include it with your request. Remember, do not send cash. You may also pay by check or money order made out to the Social Security Administration.

Common mistakes

Filling out the SSA-7050-F4 form can be a straightforward process, but there are common mistakes that people often make, which can delay or complicate their requests. One frequent error involves not providing the correct name as it appears on the individual's Social Security card. It's essential to ensure that the first and last names match exactly. If there are any discrepancies, the Social Security Administration (SSA) may not be able to locate the correct earnings information.

Another common mistake is failing to specify the type of earnings information required. The form clearly asks the applicant to choose only one type, whether it be a detailed itemized statement or certified yearly totals. If this choice is not made, the SSA will return the request, which can be a frustrating setback for the applicant.

In addition, people often overlook filling in the years of earnings they need. This oversight can lead to further delays. Including the specific years ensures that SSA can process the request accurately and efficiently. Skipping this step may lead to a general response that does not meet the applicant’s needs.

Moreover, many applicants forget to include payment. The fees for different types of information are specified clearly. If the appropriate fee is not enclosed with the form, SSA will return the request, causing unnecessary delay. It’s vital to double-check the payment amount required based on the type of statement requested.

Another mistake is neglecting to sign the form or provide additional documentation when required. If the signature is by mark (an "X"), it must be witnessed by two individuals. Failure to follow this rule will lead to rejection of the form. Always ensure that all necessary signatures and documentation are properly included before sending the request.

Lastly, applicants sometimes forget to mail the request to the correct SSA address. The SSA has specified the correct mailing address, and any deviations may result in misdelivery or a delay in processing. It's crucial to double-check the mailing instructions and ensure the completed form is sent to the proper destination.

Documents used along the form

The SSA-7050 F4 form is essential for individuals requesting Social Security earning information. However, several other forms and documents accompany this request to ensure all necessary information is clear and accessible. Below is a summary of common forms and documents often associated with the SSA-7050 F4 form.

Form SSA-827 - This is an Authorization for the Social Security Administration to release information to third parties. It is particularly important when someone else is making a request on behalf of the person whose earnings information is sought.
Form SSA-24 - This form is used to apply for a Social Security Disability Insurance appeal. Often, individuals need both disability benefits and earning records during this process.
Form SSA-2890 - Requesting information needed for special situations, this form allows individuals to obtain information related to specific needs such as adjustments in benefits or verification for loans or mortgages.
Form SSA-1099 - This document serves as the annual statement of Social Security income, which recipients must report for tax purposes. It provides a summary of income received in the previous tax year.
Form SSA-1383 - A statement regarding a person’s eligibility for certain benefits, used mainly when appealing or reviewing eligibility status for Social Security programs.
Form SSA-7004 - This is mainly utilized for requesting a Taxpayer Identification Number (TIN) Application. Individuals may need this for reporting purposes alongside their earnings information.
Birth Certificate - When the request involves a deceased person or a minor, a birth certificate may be necessary to provide proof of relationship. It's critical for establishing identity and relationships in such cases.
Death Certificate - Required for requests related to deceased individuals, this document verifies death and supports claims for earning records or benefits associated with the deceased.

Collectively, these forms and documents support the processing of requests for Social Security earning information. Having the right paperwork helps facilitate a smoother and more efficient experience when dealing with the Social Security Administration.

Similar forms

Form SSA-7050-F2: This form also requests earnings information but focuses on requests made by third parties, such as legal representatives or guardians. It ensures that the information provided adheres to privacy regulations.
Form SSA-7004: With this form, you can request a Social Security Statement that provides an overview of your earnings and benefits. Unlike SSA-7050-F4, it summarizes earnings without detailed itemization.
Form SSA-1099: This document reports annual earnings and benefits paid to recipients. It is similar in that it provides information on earnings but focuses on amounts received during a specific tax year.
Form SSA-1003: This application allows individuals to request benefits based on their earnings record. It relates to SSA-7050-F4 by facilitating access to earnings data necessary for determining eligibility for benefits.
Form SSA-7028: This form is used to request information for the purpose of calculating retirement benefits. It shares similarities in intent with SSA-7050-F4, as both focus on obtaining earnings data for Social Security purposes.
Form SSA-827: This authorization form is required to release your medical or financial information for various SSA programs. It connects to SSA-7050-F4 by ensuring the correct protocols are followed when accessing personal earnings information.

Dos and Don'ts

Filling out the SSA-7050-F4 form correctly is essential to ensure your request for Social Security earning information is processed without delays. Below is a list of nine things you should and shouldn't do when completing this form.

Do use your name exactly as it appears on your Social Security card.
Don't submit multiple requests on one form; only one Social Security Number (SSN) per request is allowed.
Do specify the type of earnings information you need clearly to avoid confusion.
Don't forget to include a daytime phone number where you can be reached if there are questions.
Do provide all required supporting documentation, especially if you are requesting information for someone else.
Don't leave out your payment; the form requires the appropriate fee to be included for processing.
Do ensure you sign the form unless you are using a mark, which then requires two witnesses.
Don't forget to mail the completed form within 120 days of signing to avoid processing issues.
Do keep a copy of your completed form for your records.

Being mindful of these points can help streamline the process, ensuring you receive the earning information you need promptly. Taking the time to fill out the form accurately will ultimately save you time and effort in the long run.

Misconceptions

Here are seven common misconceptions about the SSA 7050 F4 form that people often have:

It's free to obtain any earnings information. Many believe all earnings information is free. However, an itemized statement of earnings comes with a fee of $92. Certified yearly totals also incur a $30 fee; non-certified yearly totals are free.
You can request someone else’s earnings without restrictions. This form requires proof of entitlement to request someone else’s earnings, whether it's a child, an incompetent individual, or a deceased person.
A certified statement is always necessary. Some think they must get a certified statement regardless of their needs. In reality, many situations do not require certification, which can save time and money.
The SSA processes requests immediately. Many expect speed in processing requests. In truth, it can take up to 120 days for the Social Security Administration to process the request.
You can use the form for any Social Security Number (SSN). This form is specific to one SSN per request, meaning you cannot combine requests for multiple SSNs on a single form.
Only current workers need to request their earnings information. Individuals who are retired or have left the workforce may also find it useful to obtain this information, especially if applying for benefits or disputing records.
The form accommodates any payment method. Incorrectly, some think they can send cash. The SSA only accepts payments via check, money order, or credit card, and cash should never be sent.

Understanding these misconceptions can help streamline the process of requesting earnings information and ensure that individuals submit their requests correctly.

Key takeaways

When preparing to fill out the SSA-7050-F4 form to request Social Security earnings information, several key points should be considered:

Single Request Per Form: You can only request earnings information for one Social Security Number (SSN) per form. Multiple requests require separate forms.
Types of Earnings Information: Choose between two types: an itemized statement of earnings, which includes employer details, or certified yearly totals, which only provide the total earnings without employer names.
Fees Apply: The itemized statement costs $92 for non-certified or $122 for certified. Certified yearly totals are $30, while non-certified totals are available for free online.
Documentation Required: If you are requesting someone's earnings information, you must provide documentation proving your relationship to the individual, or legal authority, along with the completed form.
Submission Guidelines: Ensure the completed form is mailed within 120 days of signing. Use the specified payment method and address to avoid delays.

Following these guidelines will help streamline the process and avoid potential issues with your request.

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