OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Missing and Discrepant Wage Reports Letter and Questionnaire

IC 9293 under ICR 202508-0960-006 · OMB 0960-0432.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form SSA-95-SM
Missing and Discrepant Wage Reports Letter and Questionnaire		 Form
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
SSA-L94-SM (current).pdf Other-Cover Letter
SSA-L94-SM (current).pdf Other-Cover Letter
SSA-L93-SM (current).pdf Other-Cover Letter
SSA-L93-SM (current).pdf Other-Cover Letter
Pamphlet.docx Other-Pamhet
Pamphlet.docx Other-Pamhet
SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Re
SSA-95-SM (revised).pdf 		Form
SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Re
SSA-95-SM (revised).pdf 		Form
SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA
SSA-97-SM (current).pdf 		Form
SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA
SSA-97-SM (current).pdf 		Form
SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Recor
SSA-95-SM2 (revised).pdf 		Form
SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Recor
SSA-95-SM2 (revised).pdf 		Form
SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Betw
SSA-97-SM2 (current).pdf 		Form
SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Betw
SSA-97-SM2 (current).pdf 		Form
SSA-95-SM (current).pdf
SSA-95-SM (No Record Questionnaire first request) (current)		IC Document
SSA-95-SM (current).pdf
SSA-95-SM (No Record Questionnaire first request) (current)		IC Document
SSA-95-SM2 (current).pdf
SSA-95-SM2 (No Record Questionnaire second request) (current)		IC Document
SSA-95-SM2 (current).pdf
SSA-95-SM2 (No Record Questionnaire second request) (current)		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted 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


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 356,800 0 0 0 0 356,800
Annual IC Time Burden (Hours) 356,800 0 0 0 0 356,800
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
SSA-95-SM (No Record Questionnaire first request) (current) 09/02/2025
SSA-95-SM2 (No Record Questionnaire second request) (current) 09/02/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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