Missing and Discrepant Wage Reports Letter and Questionnaire

Social Security Administration
Retirement, Survivors and Disability Insurance
Important Information, Immediate Reply Required
Date: MM/DD/YY
EIN: 99-9999999

COMPANY NAME
ADDRESS 1
ADDRESS 2
CITY, ST 99999-9999
We recently found that our wage reports for your employees may not be correct. We need your help to
correct them.
Each year we check our processed wage totals for the Forms W-2 you sent us against totals for the Forms
941, 943, 944 or Form 1040 Schedule H employment tax returns you filed with the Internal Revenue
Service (IRS).
NOTE: Effective January, 2008 SSA will no longer accept magnetic media submissions. We encourage
you to file your wage reports electronically, using Business Services Online (BSO). Additional information
on wage report filing can be obtained by accessing our employer reporting website at:
www.socialsecurity.gov/employer.
What We Found
The wage totals did not match for the year shown on the enclosed questionnaire. As explained in the
enclosed pamphlet, there may be several reasons why these totals do not match. Most often, it is because
we have not received all the Forms W-2 that are due or smaller W-2 wage amounts were reported to us than
were reported to IRS on your Forms 941, 943, 944 or Schedule H.
What You Should Do
Please check your records to make sure you have correctly reported your employees' wages or to see if
there is any other reason for the different wage totals. Then, fill out the enclosed questionnaire and return it
with the requested information within 45 days.

Enclosure(s):
Pub 16-002
Return Envelope

See Next Page

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FORM APPROVED OMB NO. 0960-0432
About the Questionnaire

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We've enclosed a pamphlet that includes information to help you complete the questionnaire.
If the questionnaire shows only IRS wage totals, it means we do not have copies of any Form W-2 wage
reports for your employees for that year. Otherwise, it shows that the Form W-2 wage totals we have in our
records are less than those on the Forms 941, 943, 944 or Schedule H returns you filed with IRS.
We've also enclosed a self-addressed envelope. If you cannot use the envelope, please mail the completed
questionnaire and requested information only to:
Social Security Administration
Metro West
P.O. Box 33021
Baltimore, Maryland 21290-3021
We cannot correct your employees' wage records unless you give us the information that we requested.
This information is important because it could affect your employees' rights to future Social Security
benefits and the amount of those benefits. Please make sure that the information you give us will resolve
the problem. You should keep your wage records for the tax year in question for the next four years.
If We Do Not Receive This Information
If you do not send the information we need to correct your employees' wage records, we will refer this
matter to the IRS. If the IRS finds that you made a reporting error, IRS may charge penalties of up to $100
per missing Form W-2 or 10 percent of the amount of income reported, whichever is greater.
If You Have Any Questions
If you have any questions about this letter, please refer to the enclosed pamphlet. If you still have questions,
please write to us at the above address or call us at 1-800-772-6270 between 7:00 A.M. and 7:00 P.M.,
Eastern time, Monday through Friday.

Carolyn L. Simmons
Associate Commissioner for
Central Operations

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PRIVACY/PAPERWORK ACT NOTICE
We are allowed to collect facts about your employees under section 205(c)(2)(A) of the Social Security Act
(42 U.S.C.) (405)(C)(2)(A). Your help will allow us to properly credit the earnings records for your
employees. You do not have to give us these facts, but, if you do not, we will refer your case to IRS.
We may also use the information you give us when we match records by computer. Matching programs
compare our records with those of other Federal, State, or local government agencies. Many agencies may
use matching programs to find or prove that a person qualifies for benefits paid by the Federal government.
The law allows us to do this even if you do not agree to it.
Explanations about these and other reasons why information you provide us may be used or given out are
available in Social Security offices. If you want to learn more about this, contact any Social Security office.

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 30
minutes to read the instructions, gather the facts, and answer the questions. SEND OR
BRING THE COMPLETED FORM TO YOUR LOCAL SOCIAL SECURITY
OFFICE. The office is listed under U. S. Government agencies in your telephone
directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
You may send comments on our time estimate above to: SSA, 6401 Security Blvd,
Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this
address, not the completed form.

SSA-L-93-SM (11-06)