SSA-7050-F4 2016 free printable template

Form Approved OMB No. 09600525Social Security AdministrationREQUEST FOR SOCIAL SECURITY EARNINGS INFORMATION *Use This Form If You Need1. Certified/Uncertified Detailed Earnings Information Includes

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How to fill out SSA-7050-F4

1. Obtain the SSA-7050-F4 form from the Social Security Administration's website or local office.
2. Provide your personal information at the top of the form, including your name, Social Security number, and address.
3. Specify the purpose for which you need the records—such as for legal, tax, or personal use.
4. Indicate the records you are requesting, such as earnings information or other specific details.
5. Include your signature and date at the bottom of the form to authorize the release of information.
6. Submit the completed form to the provided address on the SSA-7050-F4 instructions.

Who needs SSA-7050-F4?

1. Individuals seeking to verify their earnings history for tax purposes.
2. People applying for loans or mortgages that require proof of income.
3. Those needing information for legal proceedings, such as divorce or child support cases.
4. Anyone wishing to verify their eligibility for Social Security benefits.

• Who needs an SSA Form 7050-F4?
• What is Form SSA-7050-F4 for?
• Is Request for Social Security Earnings Information accompanied by other forms?
• • When is Form SSA-7050-F4 due?
  • How do I fill out Request for Social Security Earnings Information?
  • Where do I send Form SSA-7050-F4?

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. 

The full name of Form SSA-7050-F4 is Request for Social Security Earnings Information.

What is Form SSA-7050-F4 for?

The Request for Social Security Earnings Information is obligatory to be filled out to inform the Social Security Administration of a taxpayer’s desire to obtain an in-depth statement of their employment records. This form is also to be filed if an individual is willing to receive other person's earning statement (in case they are entitled to do so).

The information requested can be helpful in terms of allowing the taxpayer to estimate their future retirement or disability benefits, or to estimate their Social Security and Medicare taxes that were paid.

Is Request for Social Security Earnings Information accompanied by other forms?

There is no need to support the Request for Social Security Earnings Information by any other documents unless the filer of the form is not requesting their earnings statement or yearly earnings totals.

The filer should not forget that there is a fee that must be paid for the request, the details can be seen here¹.

When is Form SSA-7050-F4 due?

The submission of the SSA-7050-F4 does not imply following any strict deadlines, yet the applicant should be aware of the timeframe within which the SSA can accomplish gathering all the requested information. Typically, a filer should expect the SSA to be preparing the response for up to four months.

How do I fill out Request for Social Security Earnings Information?

The properly completed SSA Form 7050-F4 implies indicating the following information:

• The full name of the person whose earnings information is being requested
• Social Security Number
• Date of Birth
• Type of information needed
• The recipient (if different from the applicant)
• Authorization by the applicant or their legal guardian
• Payment details

Where do I send Form SSA-7050-F4?

The completed form must be filed with the SSA; the address depends on whether the applicant turned to a private contractor for help. Both of the relevant addresses are indicated in the text of the form on Page 4.

 

¹check the link — https://www.ssa.gov/forms/ssa-7050.html

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People Also Ask about

What is a CMS L564 Request for employment information?

This form is used for proof of group health care coverage based on current employment. This information is needed to process your Medicare enrollment application. The employer that provides the group health plan coverage completes the information about your health care coverage and dates of employment.

Can I submit form CMS L564 online?

You can complete the Part B SEP online or you can mail your completed CMS 40B, Application for Enrollment in Medicare - Part B (Medical Insurance) and CMS L564 - Request for Employment Information to your local Social Security office.

What is OMB No 0938 0787?

OMB 0938-0787 This information is needed to determine whether an individual is eligible to enroll in Medicare Part B or Premium Part A under the provisions of section 1837(i) of the Social Security Act (The Act) and/or qualify for a reduction in the premium amount under the provisions of section 1839(b) of the Act.

Who completes CMS L564 form?

This form is used for proof of group health care coverage based on current employment. This information is needed to process your Medicare enrollment application. The employer that provides the group health plan coverage completes the information about your health care coverage and dates of employment.

Can I submit my Medicare Part B application online?

Apply online (at Social Security) – This is the easiest and fastest way to sign up and get any financial help you may need. You'll need to create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online. Call 1-800-772-1213. TTY users can call 1-800-325-0778.

Where do I mail form CMS L564?

If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, MD 21244-1850.

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What is SSA-7050-F4?

SSA-7050-F4 is a form used by individuals to request a copy of their Social Security earnings record or another record related to their Social Security benefits from the Social Security Administration (SSA).

Who is required to file SSA-7050-F4?

Anyone who wishes to obtain their Social Security earnings record or related information from the SSA may file the SSA-7050-F4. This form can be filed by individuals or their representatives.

How to fill out SSA-7050-F4?

To fill out SSA-7050-F4, you need to provide your personal identification information, specify the type of record you are requesting, and sign the form. It's important to follow the instructions provided on the form carefully.

What is the purpose of SSA-7050-F4?

The purpose of SSA-7050-F4 is to facilitate individuals in obtaining their Social Security records for purposes such as verifying earnings, applying for benefits, or correcting errors in their earnings history.

What information must be reported on SSA-7050-F4?

The information that must be reported on SSA-7050-F4 includes the individual's full name, Social Security number, date of birth, and the specific records requested. Additional identifying information may also be required.