OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Employer Verification of Earnings After Death

OMB 0960-0472 ยท SSA.

OMB 0960-0472

When SSA records show a wage earner is deceased and we receive wage reports from an employer for the wage earner for a year subsequent to the year of death, SSA mails the employer Form SSA-L4112 (Employer Verification of Earnings After Death). SSA uses the information Form SSA-L4112 provides to verify wage information previously received from the employer is correct is correct for the employee and the year in question. The respondents are employers who report wages for employees who have died.

The latest form for Employer Verification of Earnings After Death expires 2026-10-31 and is listed under ICR 202206-0960-003.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-L4112 Employer Verification of Earnings After DeathForm
Addendum - 0472.docx Supplementary Document
Supporting Statement - 0472 (Final).docxSupporting Statement A
Employer Verification of Earnings After Death Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202206-0960-003 Revision of a currently approved collection 2022-09-01 Approved without change
201911-0960-008 No material or nonsubstantive change to a currently approved collection 2020-01-02 Approved without change
201901-0960-005 Revision of a currently approved collection 2019-05-24 Approved with change
201601-0960-002 Revision of a currently approved collection 2016-04-07 Approved without change
201506-0960-003 No material or nonsubstantive change to a currently approved collection 2015-06-09 Approved without change
201302-0960-003 Revision of a currently approved collection 2013-05-29 Approved without change
201003-0960-004 Revision of a currently approved collection 2010-06-02 Approved without change
200705-0960-018 Extension without change of a currently approved collection 2007-07-03 Approved without change
200405-0960-014 Revision of a currently approved collection 2004-05-27 Approved without change
200105-0960-001 Extension without change of a currently approved collection 2001-05-03 Approved without change
199804-0960-007 Extension without change of a currently approved collection 1998-04-09 Approved without change
199503-0960-002 Reinstatement without change of a previously approved collection 1995-03-02 Approved without change
199112-0960-009 Revision of a currently approved collection 1991-12-31 Approved without change
198909-0960-002 No material or nonsubstantive change to a currently approved collection 1989-09-08 Approved with change
198902-0960-004 New collection (Request for a new OMB Control Number) 1989-02-21 Approved without change