Missing and Discrepant Wage Reports Letter and Questionnaire

Form Approved
OMB No. 0960-0432

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

COMPANY NAME
ADDRESS 1
ADDRESS 2
CITY, ST 99999-9999

Important Information, Immediate Reply Requested
We recently found that our wage reports submitted 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 (Form 1040) employment tax returns you filed with the Internal Revenue Service
(IRS).
NOTE: SSA no longer accepts 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
W-2/W-2c totals processed by SSA (Social Security wages and tips, and Medicare wages and tips) did not match the
totals reported to IRS for the EIN and tax year above. (See questionnaire enclosed). 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 SSA us than were reported to IRS on your Forms 941, 943, 944
or Schedule H (Form 1040).
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

SSA-L-93-SM (11-07)
999999999-99-MMDDYY

Form Approved
OMB No. 0960-0432

Page 2 of 5
About 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 tax 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 (Form 1040) returns you filed with the IRS.
We have've enclosed a pamphlet entitled “Don’t Let Your Employees Down” that includes information to help you
complete the questionnaire. Also see “Reconciliation Process” at. www.socialsecurity.gov/employer.
For your convenience we have 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. Always keep
your wage records for four (4) years to back up your wage and tax reports, should SSA or IRS have questions about
them at a later date.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, they IRS may charge you a penalty. 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 that cannot be answered by the enclosed pamphlet or the website, 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 1-800772-6270 between 7:00 A.M. and 7:00 P.M., Eastern time, Monday through Friday.

Carolyn L. Simmons
Associate Commissioner for
Central Operations

SSA-L-93-SM (11-07)

999999999-99-MMDDYY

Form Approved
OMB No. 0960-0432

See Revised Privacy Act
Statement

Page 3 of 5

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. 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. See Revised Paperwork

Reduction Act Statement

SSA-L-93-SM (11-07)
999999999-99-MMDDYY

SSA will insert the following revised Privacy Act Statement into the form
at its next scheduled reprinting:
Missing and Discrepant Wage Reports and Letter Questionnaire, SSA-L-93-SM
Privacy Act Statement
Collection and Use of Personal Information

Section 205(c)(2)(A) of the Social Security Act, as amended (42 U.S.C. 405(c)(2)(A),
authorizes us to collect this information. We will use the information you provide to help
us to properly credit the earnings records for your employees. The information you
provide on this form is voluntary. However, failure to provide all or part of the requested
information will result in referral of your case to the Internal Revenue Service.
We rarely use the information you provide on this form for any purpose other than for the
reasons explained above. However, we may use it for the administration and integrity of
Social Security programs. We may also disclose information to another person or to
another agency in accordance with approved routine uses, which include but are not
limited to the following:
1. To enable a third party or an agency to assist Social Security in establishing
rights to Social Security benefits and/or coverage;
2. To comply with Federal laws requiring the release of information for Social
Security records (e.g., to the Government Accountability Office, General
Services Administration, National Archives Records Administration, and the
Department of Veterans Affairs);
3. To make determinations for eligibility in similar health and income
maintenance programs at the Federal, State, and local level; and
4. To facilitate statistical research, audit or investigative activities necessary to
assure the integrity of Social Security programs.
We may also use the information you provide in computer matching programs.
Matching programs compare our records with records kept by other Federal, State, or
local government agencies. Information from these matching agencies can be used to
establish or verify a person’s eligibility for Federally-funded or administered benefit
programs and for repayment of payments or delinquent debts under these programs.
A complete list of routine uses for this information is available in our System of Records
Notices entitled Earnings Recording and Self-Employment Income System 60-0059. The
notice, additional information regarding this form, and information regarding our system
and programs, are available on-line at www.socialsecurity.gov or at your local Social
Security office.

SSA will insert the following revised PRA Statement into the form at its
next scheduled reprinting:
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 only
comments relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore,
MD 21235-6401.