Employer Verification of Earnings After Death

OMB 0960-0472

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. We are making revisions to correct the name of the operation center on the return address.

The latest form for Employer Verification of Earnings After Death expires 2022-09-30 and can be found here.

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