Supplemental Security Income Mobile Wage Reporting (SSIMWR)

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Screen Images and Interactions
 Access Code Entry – To be removed in September 2013 







Terms of Service 


 



Full Terms of Service wording: 
    • I understand that this application contains U.S. Government information. 
    • I consent to the monitoring of my use of this application to ensure its appropriate use.
    • I understand that it is a federal crime to:
        ◦ Give false or misleading statements to obtain information in Social Security records; or
        ◦ Deceive the Social Security Administration of an individual’s identity.  
    • I understand that unauthorized use of, or access to, this application may subject me to criminal or civil penalties, or both.
    • I understand that if I am submitting wages for someone else, I must have his or her permission to do so. 
    • I understand that Social Security may stop me from using this service if it finds or suspects misuse.

Enter PII 

1st Appearance of Screen 			2nd / 3rd Appearance of Screen 
(Before Errors - Empty)				(After Errors - prepopulated)

          





Confirm PII 

Standard Name Display		   With Other Last Name Displayed

     










Reporting Path Choice














Wage Entry for Self 

 













Confirm Wage Report for Self












Enter Wages

1st Appearance of Screen 						
(Before Errors - Empty)	









2nd / 3rd Appearance of Screen 
(After Errors - prepopulated)






















Confirm Wage Report for Other 













Interim Successful Submission- No changes
















Final Successful Submission – Within GK Dates











Final Successful Submission – Outside GK Dates












Log Out Confirmation
























Privacy Act Statement 


Full Privacy Act Statement Wording:
Title 5 U.S.C. sections 205(a) and 1631(e), and Executive Order 9397, as amended, authorize us to collect this information.  We will use the information you provide to determine eligibility for Supplemental Security Income.

Furnishing us this information is voluntary.  However, failure to provide all or part of the information could prevent us from making an accurate and timely decision on Supplemental Security Income benefits.

We rarely use the information you supply for any purpose other than for making a determination relating to Supplemental Security Income benefits.  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 from Social Security records (e.g., to the Government Accountability Office and 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 and improvement of Social Security programs (e.g., to the Bureau of the Census and private concerns under contract to Social Security).

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 programs 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 Systems of Records Notice entitled, Supplemental Security Income Record, 60-0103.  This notice, additional information, and information regarding our programs and systems, are available on-line at www.socialsecurity.gov or at your local Social Security office.

















Paperwork Reduction Act-No changes




Full Paperwork Reduction Act Wording:
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 5 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 report.
The OMB control number for the Supplemental Security Income Telephone Wage Reporting System and the associated instructions package is 0960-0715; expiration date 07/31/2013.



Error Message Screens

Wage Reporting Period Closed – To be removed in September 2013 















Service Unavailable- No changes
















Cannot Connect- No changes













Access Code Error: 1st and 2nd Strikes – To be removed in Sept 2013

















Access Code Error: 3rd Strike – To be removed in September 2013


















In-line Field Error (example)- No changes













Verification/Exclusion Check Error: 1st and 2nd Strikes- No changes

















Verification/Exclusion Check Error: 3rd Strike- No changes

















Terms of Service Refusal- No changes



















Time Out Warning— No changes


















Time Out Error—No changes
















Close This App Warning---No changes