Title of Information Collection and Form Number(s)

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

Supporting Statement for Form SSA-7050-F4
Request for Social Security Earnings Information
20 CFR 401.100 and 404.810
OMB No. 0960-0525

A. 	Justification

    1. Introduction/Authoring Laws and Regulations
The Social Security Administration (SSA) uses the Request for Social Security Earnings Information, Form SSA-7050-F4, for Social Security number (SSN) holders or their legal representatives to request an Itemized Statement of Earnings (Form SSA-1826) for various non-program related reasons.  Section 205(c)(2)(A) of the Social Security Act (Act) mandates the disclosure of earnings.  Section 20 CFR 404.810 of the Code of Federal Regulations describes the information individuals must provide to obtain a statement of earnings and a benefit estimate statement.  Section 20 CFR 401.100 describes the rules for disclosure of official records and information.

    2. Description of Collection
SSA uses the information the respondent provides on Form SSA-7050-F4 to verify the wage earner has:  (1) earnings; (2) the right to access the correct Social Security Record; and (3) the right to request the earnings statement.  If we verify all three items, SSA produces an Itemized Statement of Earnings (Form SSA‑1826) and sends it to the requester.  Respondents are wage earners and their authorized representatives who are requesting Itemized Statement of Earnings records.

On the form, the respondent has multiple options to select from.  First, respondents must choose between an Itemized Statement of Earnings or a Certified Yearly Total of Earnings.  The Itemized Statement of Earnings provides the customer with a detailed record of their earnings history.  It allows the individual to identify with which organizations they have been employed and the earnings associated with that employment.  This involves looking at the DEQY (Detail Earnings Query) to obtain this information for reproduction (manual process).  By contrast, the Certified Yearly Total of Earnings only includes the total earnings for each year but does not include the names and addresses of employers and sends it to the requestor.  If we cannot verify the items listed above, we inform the respondent we cannot provide them with the requested Statement of Earnings or Certified Yearly Totals of Earnings due to this mismatch.  The agency charges respondents for sending them an Itemized Statement of Earnings, or for a Certified Yearly Totals of Earnings.  In contrast, Non-Certified requests are free and available through the respondents my Social Security account.  Non-Certified requests typically involve circumstances when an individual wishes to check their earnings history or they need to supply proof of their earnings amount to a third-party such as a rental company or private landlord.

Additionally, respondents may elect to have their Itemized Statements of Earnings “certified.”  Respondents typically seek certified records when an individual needs proof of earnings for court purposes or other similar circumstances (e.g. child support cases).  Non-Certified requests typically involve circumstances when an individual wishes to check their earnings history or they need to supply proof of their earnings amount to a third-party such as a rental company or private landlord.  Regardless if a record is certified or not, SSA still checks the same systems and performs the same procedures to confirm the earnings record.  However, a certified request comes with an official letter that contains the agency seal, ribbons/grommets, and an additional statement certifying that these earnings have been reviewed and are true and correct.

SSA’s Finance and Management office sets fee rates, and those rates encompass all of the overhead and component costs to process these requests.

There are no psychological costs associated with completing Form SSA-7050-F4, because it requests only basic information about the respondent’s order (an Itemized Statement of Earnings or Certified Yearly Totals of Earnings Statement), and credit card information.  We designed the form for Social Security number (SSN) holders or their legal representatives to request Social Security Earnings Information as easily as possible through a straightforward method.  SSA uses the information provided on Form SSA‑7050-F4 solely to verify that the wage earner has earnings, the right to access the correct Social Security record, and the right to request the earnings statement.  The form does not ask for sensitive or subjective information that could cause emotional distress.  Additionally, SSA follows strict privacy and security protocols to protect respondents’ information, further reducing any potential for concern.

Respondents include wage earners and their authorized representatives who request Itemized Statement of Earnings records or Certified Yearly Totals of Earnings.

    3. Use of Information Technology to Collect the Information
We currently make Form SSA-7050-F4 available on the Internet to respondents in a fillable PDF format which the respondents can complete, print, and sent to SSA for processing.  Once we receive the form showing identifying information, and the authorizing signature, we review it manually.  Following review, we key the data into an electronic program developed to control requests and to obtain the necessary information.  In addition, we also made a request for this information available electronically through the respondents’ my Social Security accounts, which allows the public to access a non-certified version of this information free of charge.  In addition, respondents can use their my Social Security accounts to access the fillable SSA-7050-F4 to complete and mail it to the administration.  We currently process payment for paper copies or certified copies through the Social Security Electronic Payment System (SERS).  SERS then generates a transaction number, which is entered into the Earnings Modification Itemized Earnings Request EMISER system, allowing the SSA technician to associate the submitted form with the individual’s SSN for processing of the SSA-1826 statement.

This collection does not currently have a fully public-facing Internet version, as we prioritized other information collections for full electronic conversions.  SSA is actively exploring secure alternatives and will continue to prioritize the protection of sensitive information as we work toward a compliant solution to allow for a fully electronic submission option.  Given that IT Mod programming is an ongoing, dynamic project, we cannot provide specific timelines for when we will be able to make any particular ICR available via Internet web-based application.  We will ultimately convert most existing ICRs to full electronic versions depending on how they fall within our overall IT Mod schema, but this may be unconnected to the PRA approval lifecycle.

    4. Why We Cannot Use Duplicate Information
The nature of the information we collect and the manner in which we collect it preclude duplication.  SSA does not use another collection instrument to obtain similar data.

    5. Minimizing Burden on Small Respondents
This collection does not affect small businesses or other small entities. 

    6. Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not collect this information, we would deny the requester’s right to obtain information about their earnings record, thus violating the mandate in Section 205(c)(2)(A) of the Act, which requires SSA to disclose earnings.  Because we only collect the information on an as needed basis, we cannot collect it less frequently.  There are no technical or legal obstacles to burden reduction.

    7. Special Circumstances 
There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.

    8. Solicitation of Public Comment and Other Consultations with the Public 
The 60-day advance Federal Register Notice published on July 31, 2026 at 91 FR 48470, and we received no public comments.  The 30-day FRN published on September 24, 2026, at 91 FR 60677.  If we receive any comments in response to this Notice, we will forward them to OMB.  We did not consult with the public in the development revision of this form.

    9. Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents. 

    10. Assurances of Confidentiality
SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.

    11. Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature.

    12. Estimates of Public Reporting Burden
Please see the burden chart below:
	
Method
of Completion
Number 
of Respondents
Frequency
of 
Response
Average Burden Per Response (minutes)
Estimated Total Annual Burden (hours) 
Average Theoretical Cost Amount (dollars)*
Total Annual Opportunity Cost (dollars) ***
SSA-7050-F4
66,800
1
11
12,247
$ 33.54*
$410,764**
* We based this figure on an average U.S. citizen’s hourly salary ($33.54), as reported by Bureau of Labor Statistics data (Occupational Employment and Wage Statistics).

** This figure does not represent actual costs that SSA is imposing on individuals; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the information collection.  

We did not include travel time as per our current management information data, respondents who complete the paper forms return them to us via mail.  Should this change in the future, we will include the language and chart for travel time to a field office.

We did not include a separate Learning Cost for this information collection, as we include the Learning Cost in the burdens listed in the chart above.

We base our burden estimates on current management information data, which includes data from years of conducting this information collection.  Per our management information data, we believe that 11 minutes accurately shows the average burden per response for learning about the program; receiving notices as needed; reading and understanding instructions; gathering the data and documents needed; answering the questions and completing the information collection instrument; scheduling any necessary appointment or required phone call; consulting with any third parties (as needed); and waiting to speak with SSA employees (as needed).  Based on our current management information data, the current burden information we provided is accurate.  The total burden for this ICR is 12,247 burden hours (reflecting SSA management information data), which results in an associated theoretical (not actual) opportunity cost financial burden of $410,764.  SSA does not charge respondents to complete our applications.

13. 	Annual Cost to the Respondents (Other) 
Participating requesters must compensate SSA for non-program-related work to ensure that the Social Security Trust Funds do not bear these costs.  Page 2 of the form explains the costs and lists the fee charged per request.  The actual charge for an Itemized Statement of Earnings or a Certified Yearly Total of Earnings to be shown on the      SSA-7050-F4 is as follows:


Type of Respondent
Number of requests
Cost per request
Annual Cost Across All Requests Per Year
Non-Certified Respondent
35,000
$49
$1,715,000
Certified Respondent
20,000
$79
$1,580,000
Certified Yearly Totals of Earnings
11,800
$30
$354,000
Total
66,880

$3,649,000

    14. Annual Cost To Federal Government
The annual cost to the Federal Government is approximately $306,750.  This estimate accounts for costs from the following areas:

Description of Cost Factor
Methodology for Estimating Cost
Cost in Dollars*
Designing and Printing the Form
Design Cost + Printing Cost
$0**
Distribution, Shipping, and Material Costs for the Form
Distribution + Shipping + Material Cost
$0***
SSA Employee (e.g., field office, 800 number, DDS staff) Information Collection and Processing Time
GS-9 employee x # of responses x processing time
$306,175
Full-Time Equivalent Costs
Out of pocket costs + Other expenses for providing this service
$0*
Systems Development, Updating, and Maintenance
GS-9 employee x man hours for development, updating, maintenance
$575
Quantifiable IT Costs
Any additional IT costs
$0*
Total

$306,750
* We have inserted a $0 amount for cost factors that do not apply to this collection.
** We centrally print this form, and are unable to provide a figure for the centralized printing.  We are unable to provide the exact figure for this form as we print it along with several other agency forms.  Since we account for the cost of the centralized printing of these forms elsewhere, we do not want to double-count the cost for the printing here.
***There is no cost to the federal government as the respondents print and mail this form; therefore, we are using a $0 cost for this.
SSA is unable to break down the costs to the Federal government further than we already have.  First, since we work with almost every US citizen, we often do bulk mailings and cannot track the cost for a single mailing.  In addition, it is difficult for us to break down the cost for processing a single form, as our technicians process several forms at once, and the time it takes to do so can vary greatly.  Also, because so many employees have a hand in each aspect of our forms, we use an estimated average hourly wage, based on the wage of our average field office employee (GS-9) for these calculations.  However, we have calculated these costs as accurately as possible based on the information we collect for creating, updating, and maintaining these information collections.
15.	Program Changes or Adjustments to the Information Collection Request
There are no changes to the public reporting burden.

16.  	Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.

17.	Displaying the OMB Approval Expiration Date
OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms.  SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval.  Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.

    18. Exceptions to Certification Statement
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

B.     	Collections of Information Employing Statistical Methods

	SSA does not use statistical methods for this information collection.