Document
ADDENDUM TO SUPPORTING STATEMENT
ICR 202609-0960-001 · OMB 0960-0525 · Object 173222600.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | ADDENDUM TO SUPPORTING STATEMENT |
| Author | Naomi |
| Last Modified By | Writer |
| File Modified | 2026-09-29 |
| File Created | 2026-09-30 |
| Conversion State | complete |
Extracted Text
Addendum to Supporting Statement for Form SSA-7050-F4
Request for Social Security Earnings Information
20 CFR 401.100 and 404.810
OMB No. 0960-0525
Minor Revisions to the Collection Instruments
We are making the following revisions:
• Change #1: On page two at section #1 DOB and DOD, we are making the following changes:
from: Date of Birth: Date of Death:
to: Date of Birth: Date of Death:
MM/DD/YYYY MM/DD/YYYY
Justification #1: When our Spanish-speaking customers use the English version of the SSA-7050 provided by their attorneys, they often write their date of birth as DD/MM/YYYY, following their cultural convention. Because we do not use this date format, we experience many Numident failures. Adding the correct format (MM/DD/YYYY) under the DOB and DOD sections will help reduce the number of rejections.
• Change #2: On page three at the bottom right “How long will it take SSA to process my request?” we are making the following changes:
from: Please allow SSA 120 days to process this request.
After 120 days, you may contact 1-800-772-1213 to
leave an inquiry regarding your request.
to: Please allow SSA 120 days to process this request.
Note: The 120 days start when the payment is
processed. After 120 days have expired, you may
contact 1-800-772-1213 to leave an inquiry regarding
your request.
Justification #2: This statement will inform the customers when the 120-day count starts.
• Change #3: On page four at the credit card exp. (on the bottom left) section, we are adding the “CVV Code”:
from: Credit Card Expiration Date
to: Credit Card Expiration Date/CVV Code
Justification #3: We require the CVV code to process the payment.
• Change #4: On page four at the credit card date section, we are adding the “CVV (3 or 4 digits)” next to the MM/YY line:
from:
(MM/YY)
to:
_____________________________________________ _____________________________________________
(MM/YY) CVV (3 or 4 digits)
Justification #4: We require the CVV code to process the payment.
• Change #5: On page three at the top right “1. Certified or Non-Certified Itemized Statement of Earnings” we are deleting a sentence, as follows:
from: Bulk submitters may email [email protected] for an alternate method of obtaining itemized earnings information.
to: Bulk submitters may email [email protected] for an alternate method of obtaining itemized earnings information. [we are deleting this sentence]
Justification #5: We are removing this sentence because the pension mailbox receives a high volume of inquiries from number holders about individual requests. We believe that referencing “bulk requests” in this section is confusing, as the public may interpret it as a faster way to receive their request.
• Change #6: On page two (2) section 2 of the Form SSA-7050,we request to change the fee for the Itemized Statement of Earnings:
from: $61.00
to: $49.00
Justification #6: We have changed the fees for this form.
• Change #7: On page two (2) section 2 of the Form SSA-7050, we request to change the fee for the Certified Yearly Totals of Earnings:
from: $35.00
to: $30.00
Justification #7: We have changed the fees for this form.
• Change #8: On page three (3) of the Form SSA-7050 Instruction, (under “Is There A Fee For Earnings Information”) we request to change the line that says we charge a $61.00 fee:
from: Yes. We charge a $61.00 fee
to: Yes. We charge a $49.00 fee
Justification #8: We have changed the fees for this form.
• Change #9: On page three (3) of the Form SSA-7050 Instruction, (under “Certified or Non- Certified Itemized Statement of Earnings”) we request to change paragraph two that says, “ We will certify the itemized earnings information for an additional $35.00 fee”:
from: We will certify the itemized earnings information for an additional $35.00 fee
to: We will certify the itemized earnings information for an additional $30.00 fee
Justification #9: We have changed the fees for this form.
• Change #10: On page three (3) of the Form SSA-7050 Instruction, (under “Certified Yearly totals of Earnings”), we request to change the line that says we charge $35 to certify yearly totals:
from: We charge $35 to certify yearly totals of earnings
to: We charge $30 to certify yearly totals of earnings
Justification #10: We have changed the fees for this form.
• Change #11: On page four (4) of the Form SSA-7050 Instruction, (under “How much do I have to pay for an Itemized Statement of Earnings?”), we request to change the Non-Certified Itemized Statement of Earnings fee:
from: $61.00
to: $49.00
Justification #11: We have changed the fees for this form.
• Change #12: On page four (4) of the Form SSA-7050 Instruction, (under “How much do I have to pay for an itemized Statement of Earnings?”), we request to change the Certified Itemized Statement of Earnings fee:
from: $96.00
to: $79.00
Justification #12: We have changed the fees for this form.
• Change #13: On page four (4) of the Form SSA-7050 Instruction, (under “How much do I have to pay for Certified yearly totals of Earnings”), we request to change the Certified yearly totals of earnings cost:
from: $35.00
to: $30.00
Justification #13: We have changed the fees for this form.
• Change #14: On page four (4) of the Form SSA-7050 Instruction, (under “You can make your payment by credit card?”), we request to change the fees in the amount charged field:
from: $35.00, $61.00, or $96.00
to: $30.00, $49.00, or $79.00
Justification #14: We have changed the fees for this form.
• Change #15: We are revising the Privacy Act Statement on this form.
Justification #15: SSA’s Office of Law and Policy is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on this form.
We will implement these revisions upon OMB’s approval. These revisions do not affect the current burden for this information collection.
Terms of Clearance
OMB placed Terms of Clearance on this Information Collection when they last approved it on 09/29/23. OMB requested that SSA pursue an option allowing an electronic method of payment for Form SSA‑7050‑F4, suggesting that the agency consider either creating a new electronic tool for electronic payments, or using a third-party payment tool (e.g., Pay.gov, or a commercial electronic payment method) to facilitate electronic payments from respondents.
SSA Response: Due to competing priorities, we have not yet implemented an electronic means for payment; however, we are in discussion with Treasury to use the Pay.gov option, and we are also reviewing other methods of payment. In addition, we are considering adding this form to Upload Documents (OMB No. 0960-0830) as an option for electronic submission. Finally, we made OMB’s requested revisions and clarification to the Supporting Statement in 2023, and we have maintained those revisions.