OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Request for Social Security Statement

OMB 0960-0466 · SSA.

OMB 0960-0466

When an individual wants a Statement of earnings or quarters of coverage, as shown in SSA records, they can request it from SSA using Form SSA-7004. The SSA-7004 is available on our website for respondents to print, complete, and mail back to SSA. SSA uses the information from Form SSA-7004 to identify a respondent’s Social Security earnings records; extract posted earnings information; calculate potential benefit estimates; produce the resulting Social Security Statements; and mail them to the requestors. The respondents are Social Security number holders requesting information about their Social Security earnings records and estimates of their potential benefits.

The latest form for Request for Social Security Statement expires 2026-08-31 and is listed under ICR 202206-0960-001.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-7004 Request for Social Security Statement (Paper Version)Form
Addendum - 0466 (Final).docxSupplementary Document
Supporting Statement - 0466 (Final).docxSupporting Statement A
Request for Social Security Statement--Paper Version Form
Request for Social Security Statement--Paper Version Other-Revised PA Statement

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202601-0960-005 Revision of a currently approved collection 2026-04-29
202206-0960-001 Revision of a currently approved collection 2022-10-03 Approved without change
201905-0960-001 Revision of a currently approved collection 2019-08-19 Approved without change
201606-0960-003 Revision of a currently approved collection 2016-09-02 Approved without change
201302-0960-002 Revision of a currently approved collection 2013-07-30 Approved without change
201203-0960-002 No material or nonsubstantive change to a currently approved collection 2012-03-20 Approved without change
201002-0960-005 Revision of a currently approved collection 2010-07-12 Approved without change
200705-0960-016 Extension without change of a currently approved collection 2007-07-03 Approved without change
200405-0960-015 Extension without change of a currently approved collection 2004-05-27 Approved without change
200109-0960-013 No material or nonsubstantive change to a currently approved collection 2001-09-24 Approved without change
200103-0960-003 Extension without change of a currently approved collection 2001-03-26 Approved without change
199802-0960-006 Revision of a currently approved collection 1998-02-23 Approved without change
199704-0960-003 No material or nonsubstantive change to a currently approved collection 1997-04-24 Approved with change
199505-0960-006 Revision of a currently approved collection 1995-05-22 Approved without change
199112-0960-004 Extension without change of a currently approved collection 1991-12-09 Approved without change
198901-0960-006 Extension without change of a currently approved collection 1989-01-19 Approved without change
198811-0960-001 New collection (Request for a new OMB Control Number) 1988-11-21 Approved without change