SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information

A small percentage of an individual's earnings are reported to SSA without a social security number (SSN) or with an incorrect name or SSN. SSA must write to the individual or to the employer asking for correction of the missing or incorrect information. These forms have been designed by SSA to meet this requirement. The respondents are self-employed individuals, employees, or an employee's employer, in situations where SSA is unable to identify the individual based on the information submitted.

The latest form for SSA-L2765, Request for Self-Employment Information, SSA-L3365, Request for Employee Information, SSA-L4002, Request for Employer Information expires 2021-01-31 and can be found here.

SSA-L2765, Request for Self-Employment Information

Federal Enterprise Architecture: Income Security - General Retirement and Disability

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