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Confidential Patient Informational+ A B C Patients Name LastFirstMiddleCityStateNicknameGenderAddress Streetwise PhoneBirthdateZipSocial Security #If patient is a minor, give parents or guardians
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The Social Security Administration (SSA) considers earnings and reports on your Social Security Statement as Social Security credits. They are used to determine if you are eligible for benefits.
Anyone who has earned income and paid Social Security taxes is required to file a statement of earnings with the SSA.
You can fill out a statement of earnings by creating an account on the SSA website and inputting your earnings information.
The purpose of a statement of earnings is to track your earnings history and ensure you receive the correct benefits when you retire.
You must report all of your earnings from work, self-employment, or other sources that are subject to Social Security taxes.
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