Information Collection

Missing and Discrepant Wage Reports Letter and Questionnaire

IC 9293 under ICR 201911-0960-001 · OMB 0960-0432.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0432 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Report Missing and Discrepant Wage Reports Letter and Questionnaire	Form
Form SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA Records Missing and Discrepant Wage Reports Letter and Questionnaire	Form
Form SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Record of Employer Report Missing and Discrepant Wage Reports Letter and Questionnaire	Form
Form SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Between IRS and SSA Records Missing and Discrepant Wage Reports Letter and Questionnaire	Form
Pamphlet.docx	Other-Pamhet
SSA-L-94-SM (Notice).pdf	Other-Cover Letter
SSA-L-94-SM (Notice).pdf	Other-Cover Letter
SSA-L-93-SM (Notice).pdf	Other-Cover Letter
SSA-L-93-SM (Notice).pdf	Other-Cover Letter
SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Re SSA-95-SM (first request) revised.pdf	Form
SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Re SSA-95-SM (first request) final - highlighted new language.pdf	Form
SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA SSA-97-SM (first request) revised.pdf	Form
SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA SSA-97-SM (first request) final- highlighted language.pdf	Form
SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Recor SSA-95-SM (second request) revised.pdf	Form
SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Recor SSA-95-SM (second request) final- highligthed new language.pdf	Form
SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Betw SSA-97-SM (second request) revised.pdf	Form
SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Betw SSA-97-SM (second request) final - highlighted language.pdf	Form
SSA-95-SM (first request) current.pdf SSA-95-SM - Current	IC Document
SSA-95-SM (first request) current.pdf SSA-95-SM - Current	IC Document
SSA-97-SM (first request) current.pdf SSA-97-SM - Current	IC Document
SSA-97-SM (first request) current.pdf SSA-97-SM - Current	IC Document
SSA-95-SM Questionnaire (second request) current.pdf SSA-95-SM second request	IC Document
SSA-95-SM Questionnaire (second request) current.pdf SSA-95-SM second request	IC Document
SSA-97-SM Questionnaire (second request) current.pdf SSA-97-SM second request	IC Document
SSA-97-SM Questionnaire (second request) current.pdf SSA-97-SM second request	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Missing and Discrepant Wage Reports Letter and Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 31.6051-2

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Electronic Capability
Form	SSA-95-SM	No	Paper Only
Form	SSA-97-SM	No	Paper Only
Other-Cover Letter		No	Paper Only
Other-Cover Letter		No	Paper Only
Form	SSA-95-SM (second request)	No	Paper Only
Form	SSA-97-SM (second request)	No	Paper Only
Other-Pamhet		No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 360,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	360,000	360,000
Annual IC Time Burden (Hours)	180,000	180,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-95-SM - Current		11/05/2019
SSA-97-SM - Current		11/05/2019
SSA-95-SM second request		11/05/2019
SSA-97-SM second request		11/05/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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