OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Statement of Agricultural Employer (Year Prior to 1988; 1988 and Later)

OMB 0960-0036 · SSA.

OMB 0960-0036

The information from Forms SSA-1002-F3 and SSA-1003-F3 is used by SSA to resolve discrepancies when farm workers allege their employers did not report their wages, or reported the wages incorrectly. If an agricultural employer has incorrectly reported wages, or failed to report any wages for an employee, SSA must attempt to correct its records by contacting the employer to obtain convincing evidence of the wages paid. The respondents are agricultural employers having knowledge of wages paid to agricultural employees. We are submitting this non-substantive Change Request to remove the signature requirement for this form.

The latest form for Statement of Agricultural Employer (Year Prior to 1988; 1988 and Later) expires 2027-05-31 and is listed under ICR 202410-0960-001.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-1002 Statement of Agricultural Employer (Years Prior to 1988)Form
Form SSA-1002 SSA-1002Form
Form SSA-1003 Statement of Agricultural Employer (1988 and Later)Form
Form SSA-1003 SSA-1003Form
Justification for the Non-Substantive Changes - Removal of Signature Requirement and addition of penalty of perjury warning (SSA-1002 1003).docxJustification for No Material/Nonsubstantive Change
Supporting Statement - 0960-0036 (Final).docxSupporting Statement A
Supporting Statement - 0960-0036 (Final).docxSupporting Statement A
Addendum 0036.doc.docxSupplementary Document
Addendum 0036.doc.docx Supplementary Document
SSA-1002 Form
SSA-1002 Form
SSA-1003 Form
SSA-1003 Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202410-0960-001 No material or nonsubstantive change to a currently approved collection 2024-11-14
202008-0960-008 Revision of a currently approved collection 2020-08-21
201609-0960-002 Revision of a currently approved collection 2017-03-15 Approved without change
201310-0960-002 Revision of a currently approved collection 2014-02-19 Approved without change
201007-0960-013 Revision of a currently approved collection 2010-11-18 Approved without change
200709-0960-005 Extension without change of a currently approved collection 2007-10-28 Approved without change
200408-0960-006 Extension without change of a currently approved collection 2004-08-20 Approved with change
200109-0960-008 Extension without change of a currently approved collection 2001-09-24 Approved without change
199806-0960-007 Extension without change of a currently approved collection 1998-06-05 Approved without change
199505-0960-004 Revision of a currently approved collection 1995-05-15 Approved without change
199112-0960-005 Reinstatement with change of a previously approved collection 1991-12-11 Approved without change
199005-0960-009 Revision of a currently approved collection 1990-05-29 Approved without change
198909-0960-010 No material or nonsubstantive change to a currently approved collection 1989-09-08 Approved with change
198706-0960-005 Extension without change of a currently approved collection 1987-06-26 Approved without change
198408-0960-013 Extension without change of a currently approved collection 1984-08-22 Approved without change
198208-0960-007 Reinstatement with change of a previously approved collection 1982-08-13 Approved without change
198108-0960-009 Extension without change of a currently approved collection 1981-08-26 Approved without change
198107-0960-004 Reinstatement with change of a previously approved collection 1981-07-29 Approved without change
198102-0960-006 No material or nonsubstantive change to a currently approved collection 1981-02-10 Approved with change
198011-0960-005 Revision of a currently approved collection 1980-11-12 Approved without change
197711-0960-002 Revision of a currently approved collection 1977-11-22 Approved without change
197511-0960-002 Extension without change of a currently approved collection 1975-11-24 Approved without change

OMB Details

SSA-1002

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Information collection instruments
FormNameElectronic accessType
Form SSA-1002Statement of Agricultural Employer (Years Prior to 1988)Fillable PrintableForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.