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This document is used by the Office of Workers’ Compensation Programs to collect earnings information from insurance carriers and self-insured employers for the purpose of processing claims under
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How to fill out Request for Earnings Information

01
Obtain a copy of the Request for Earnings Information form.
02
Fill in your personal details such as name, address, and social security number.
03
Specify the time period for which you need the earnings information.
04
Include any necessary documentation that supports your request.
05
Sign and date the form.
06
Submit the form to the appropriate agency, either online or via mail.

Who needs Request for Earnings Information?

01
Individuals applying for government benefits.
02
Those seeking to verify their earnings for loan applications.
03
Retirees needing to confirm their income for pension calculations.
04
Taxpayers preparing their annual tax returns.
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People Also Ask about

This is simply a certified version of the online statement you can download for free. You may need this if you need a certified version of your earnings history. Otherwise, you probably don't need a certified copy. For a certified copy of your yearly earnings totals, the SSA charges $44.
Who needs an SSA Form 7050-F4? An individual taxpayer should file Form SSA-7050-F4 in case they want to obtain an itemized earnings statement (either certified or noncertified, including the names of employers) or certified yearly earnings totals, providing no employment details, only the earnings.
If you need a copy of your earnings statement, you're entitled to requesting and receiving one from your current or former employers. Unfortunately, this process isn't always fast. If you need proof of employment and pay right away you'll need a different option.
You think we made a mistake when we decided that you were overpaid, or if you disagree with the amount of your overpayment. Instead, please complete the SSA-561, Request for Reconsideration.
You can also use Form 4506-T, Request for Transcript of Tax Return to request a wage and income transcript.

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Request for Earnings Information is a form used to formally request information regarding an individual's or entity's earnings for a specific time period, typically related to tax, financial, or legal purposes.
Individuals or entities seeking to verify or obtain details about earnings for purposes such as tax assessments, legal matters, or benefit calculations are required to file a Request for Earnings Information.
To fill out the Request for Earnings Information, one must provide personal identifying information, details about the earnings being requested (like dates and types of income), and any necessary identification or documentation required by the requesting agency.
The purpose of the Request for Earnings Information is to obtain accurate and official information regarding an individual's or entity's earnings to assist in various financial decisions, tax reporting, or legal proceedings.
The information that must be reported on the Request for Earnings Information typically includes the requester’s personal details, the time frame for the earnings requested, types of earnings (wages, self-employment income), and any relevant identification numbers.
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workers' compensation insurance claims Longshore Harbor Workers' Compensation Act employment compensation federal employees reimbursement claims processing self-insured insurance carrier government document

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