Form Ssa 7004

Form SSA-7004, Request for Social Security Statement, is used by individuals requesting detailed information about their previous earnings that count toward their ability to eventually qualify for social security benefits. Read the form carefully to make sure that you choose the right type of statement for your needs. Depending on the statement requested, you may also be required to pay a fee.

What is a SSA 7004?

This form will be used by the Social Security Administration. A Form SSA-7004 is known as a Request for Social Security Statement. This form will be used by individuals who want to get detailed information about their earnings that count towards their social security benefits. This will include all earnings that have had social security taxes withheld. It will list how much the individual is entitled to in regards to retirement or disability benefits.
To get your statement, you will need to include your personal information. This will allow the Social Security Administration to identify you and pull up your records. You will also need to select which type of statement you are requesting. Each type of statement has a different fee associated with it. Be sure to list the years for which you want to see your earnings. You can also request that your statement be certified.

How to complete an SSA 7004 (Step by Step)

To complete a SSA-7004, you will need to provide the following information:

  • Name shown on social security card
  • Social security number
  • Date of birth
  • Other social security numbers you have used
  • Gender
  • Last year’s actual earnings covered by social security
  • This year’s estimated earnings covered by social security
  • Age at which you plan to stop working
  • Average yearly amount that you think you will earn between now and when you plan to stop working
  • Whether you want the statement send to you or another person or organization
  • Signature
  • Phone number
  • Date  

When you have completed the form, you should mail it to:

Social Security Administration
Wilkes Barre Data Operations Center
P.O. Box 7004
Wilkes Barre, PA 18767-7004

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Sample Form Ssa 7004

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Sample Form Ssa 7004

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