OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Employment Relationship Questionnaire

OMB 0960-0040 · SSA.

OMB 0960-0040

When SSA needs information to determine a worker’s employment status to maintain a worker’s earning records, the agency uses Form SSA-7160, Employment Relationship Questionnaire, to determine the existence of an employer-employee relationship. We use the information to develop the employment relationship; specifically, to determine whether a beneficiary is self employed or an employee. The respondents are individuals, households, businesses, and state or local governments seeking to establish their status as employees, and their alleged employers. We are submitting this non-substantive change to remove the signature line and replace the Penalty of Perjury Statement with a Penalty of Perjury Warning.

The latest form for Employment Relationship Questionnaire expires 2026-09-30 and is listed under ICR 202404-0960-007.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-7160-F4 Employment Relationship QuestionnaireForm
Form SSA-7160-F4 Employment Relationship QuestionnaireForm
Justification for the Non-Substantive Changes - 0960-0040 (Removal of Signature Requirement)).docx Justification for No Material/Nonsubstantive Change
Justification for the Non-Substantive Changes - 0960-0040 (Removal of Signature Requirement)).docx Justification for No Material/Nonsubstantive Change
Addendum - 0040 (Final).docx Supplementary Document
Addendum - 0040 (Final).docx Supplementary Document
Supporting Statement - 0040 (Final).docxSupporting Statement A
Supporting Statement - 0040 (Final).docxSupporting Statement A
Employment Relationship Questionnaire Form
Employment Relationship Questionnaire Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202404-0960-007 No material or nonsubstantive change to a currently approved collection 2024-04-26 Approved without change
202109-0960-008 Revision of a currently approved collection 2021-09-30 Approved without change
201804-0960-006 Revision of a currently approved collection 2018-09-03 Approved without change
201506-0960-012 Extension without change of a currently approved collection 2015-09-18 Approved without change
201207-0960-007 Revision of a currently approved collection 2012-10-31 Approved with change
200907-0960-007 Extension without change of a currently approved collection 2009-12-10 Approved without change
200609-0960-013 Extension without change of a currently approved collection 2006-11-09 Approved without change
200401-0960-001 Extension without change of a currently approved collection 2004-01-09 Approved without change
200012-0960-001 Extension without change of a currently approved collection 2000-12-13 Approved without change
199710-0960-002 Extension without change of a currently approved collection 1997-10-29 Approved without change
199408-0960-005 Extension without change of a currently approved collection 1994-08-17 Approved without change
199106-0960-002 Revision of a currently approved collection 1991-06-27 Approved without change
198908-0960-013 No material or nonsubstantive change to a currently approved collection 1989-08-25 Approved with change
198808-0960-003 Extension without change of a currently approved collection 1988-08-18 Approved without change
198706-0960-007 Revision of a currently approved collection 1987-06-24 Approved without change
198408-0960-002 Reinstatement with change of a previously approved collection 1984-08-09 Approved without change
198003-0960-004 Extension without change of a currently approved collection 1980-03-25 Approved without change
198001-0960-005 Reinstatement without change of a previously approved collection 1980-01-31 Approved without change
197809-0960-008 Extension without change of a currently approved collection 1978-09-21 Approved without change
197809-0960-007 Extension without change of a currently approved collection 1978-09-21 Approved without change
197804-0960-023 No material or nonsubstantive change to a currently approved collection 1978-04-07 Approved with change