Date: MM/DD/YYYY Page 4 of 6
SECOND REQUEST
EMPLOYER QUESTIONNAIRE
DISCREPANCY BETWEEN IRS AND SSA RECORDS
IRS records show that, for the
year below, you paid Social Security and/or Medicare taxes on more
employee wages than SSA processed. The SSA processed wage amount is
based on your Forms W-2 and W-3 reports. The total wages on your
Forms W-2 and W-3 for a year should equal the sum of the amounts that
you report quarterly or annually to IRS on your Forms 941, 943, 944
or on
Schedule H (Form 1040).
IRS/SSA Data for Tax Year: YYYY EIN: 99-9999999
Employer Name: Employer Name
Soc. Security Wages Medicare Wages/Tips
Amount Reported on W-3: $999,999.00 $999,999.00
Amount Processed by IRS: $999,999.00 $999,999.00
Amount Processed by SSA:
(from Forms W-2) $999,999.00 $999,999.00
Difference Between IRS
and SSA Processed
Amounts: $999,999.00 $999,999.00
Soc. Security Tip Totals
Amount Reported on W-3: $999,999.00
Amount Processed by IRS: $999,999.00
Amount Processed by SSA:
(from Forms W-2) $999,999.00
Difference Between IRS
and SSA Processed
Amounts: $999,999.00
CHECK AND COMPLETE
Check
and complete any items that apply to your wage report for the tax
year shown above.
1. ( ) I did not file
Forms W-2 with SSA. I am now taking the following action (check one):
( ) Enclosing
the original Copy A of paper Forms W-2 and W-3, or
SSA-97-SM (11-07)
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Page 5 of 6
( ) Sending SSA an electronic file.
Caution:
You must identify this as a reconciliation file when you submit it!
Enclose the electronic receipt showing the Wage File ID (WFID) as
proof of filing.
2. ( ) I filed Forms
W-2 under the EIN for the TY shown above. I am now taking the
following action for the wages I previously reported (check one):
( ) Enclosing
legible copies of paper Forms W-2 and W-3, or
( ) Sending SSA an electronic file.
Caution:
You must identify this as a reconciliation file when you submit it!
Enclose the electronic receipt showing the Wage File ID (WFID) as
proof of filing.
3. ( ) The Form W-2
amounts I reported earlier are incorrect. (Enclose Copy "A"
of paper Forms W-2c and W-3c and attach legible paper copies of the
corrected tax report if filed with IRS.)
4. ( )
The Form W-2 amounts I reported earlier are correct. I
incorrectly reported wage totals to IRS.
(Attach legible
paper copies of the corrected tax report filed with IRS.)
5.
( ) The difference is due to sick pay from a third party.
(Attach an explanation that shows the name and
EIN of the third
party and the dollar amounts involved.)
6. ( ) I
cannot explain the difference between SSA and IRS records. (Attach
legible paper copies of Forms W-2 and W-3 and the tax reports filed
with IRS.)
7. ( ) I reported the same
correct wage amounts to IRS that I reported to SSA. However, the IRS
amounts
shown above are incorrect. (Attach legible paper copies of the tax reports filed with IRS.)
8.
( ) Other
___________________________________________________________________________
___________________________________________________________________________
_________________________________________________________ ( ) ______________________
Your Name and Title Daytime Phone, with area code
SSA-97-SM (11-07)
999999999-04-MMDDYY
Page 6 of 6
INFORMATION
ABOUT THE DATA YOU SEND SSA
The
name, Social Security number and wage amounts on the Forms W-2 must
be readable and complete. If we cannot read all information on the
documents you submit, or if any of these items are missing, we cannot
add the wages to the employee's wage record. If you need blank copies
of the Forms W-2 or W-3, call IRS at 1-800-829-3676. If your copies
of the Forms W-2 are illegible, please prepare duplicates on blank
copies of the Forms W-2. Make sure the Forms W-2 show the year for
which the wages are being reported.
Note:
If you send 250 or more wage items to us, you must file your wage
reports electronically in accordance with Publication 42-007:
Specifications for
Filing Forms W-2 Electronically (EFW2).
For more To get
more information, go to our website at
www.socialsecurity.gov/employer or call SSA's Employer Reporting
Branch at 1-800-772-6270 from 7:00 A.M. to 7:00 P.M., Eastern time,
Monday through Friday.
RETURN THIS QUESTIONNAIRE
Please send all requested information to:
Social Security Administration, Metro West
P.O. Box 33021
Baltimore, Maryland 21290-3021
Do not send cash, checks or money orders to SSA. Tax payments are payable to the Internal Revenue Service.
SSA-97-SM (11-07)
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File Type | application/msword |
Author | 889123 |
Last Modified By | 889123 |
File Modified | 2011-03-22 |
File Created | 2011-03-22 |