Get SSA-7050-F4 2021-2024

Form SSA-7050-F4 03-2019 Discontinue Prior Editions Social Security Administration Page 1 of 4 OMB No. 0960-0525 REQUEST FOR SOCIAL SECURITY EARNING INFORMATION Use This Form If You Need 1. Please print the signee s name next to the mark X on the signature line above. 1. Signature of Witness Address Number and Street City State and ZIP Code INFORMATION ABOUT YOUR REQUEST You may use this form to request earnings information for one ONE Social Security Number SSN How do I get my earnings statement You must complete the attached form. Tell us the specific years of earnings you want type of earnings record and provide your mailing address. DO NOT USE THIS FORM TO REQUEST YEARLY EARNINGS TOTALS Yearly earnings totals are free to the public if you do not require certification. To obtain FREE yearly totals of earnings visit our website at www. ssa.gov/myaccount. Privacy Act Statement Collection and Use of Personal Information Section 205 of the Social Security Act as amended authorizes us to collect the information on this form. We will use the information you provide to identify your records and send the earnings information you request. Ssa.gov/myaccount. Privacy Act Statement Collection and Use of Personal Information Section 205 of the Social Security Act as amended authorizes us to collect the information on this form. We will use the information you provide to identify your records and send the earnings information you request. Completion of this form is voluntary however failure to do so may prevent your request from being processed. We rarely use the information in your earnings record for any purpose other than for determining your entitlement to also disclose information to another person or to another agency in accordance with approved routine uses which include but are not limited to the following 1. To facilitate statistical research audit or investigative activities necessary to assure the integrity and improvement of Social Security programs. A complete list of routine uses for earnings information is available in our Systems of Records Notices entitled the Earnings Recording and Self-Employment Income System 60-0059 the Master Beneficiary Record 60-0090 and the SSA-Initiated Personal Earnings and Benefit Estimate Statement 60-0224. Certified/Non-Certified Detailed Earnings Information Includes periods of employment or self-employment and the names and addresses of employers. 2. Certified Yearly Totals of Earnings Includes total earnings for each year but does not include the names and addresses of employers. DO NOT USE THIS FORM TO REQUEST YEARLY EARNINGS TOTALS Yearly earnings totals are free to the public if you do not require certification* To obtain FREE yearly totals of earnings visit our website at www. Completion of this form is voluntary however failure to do so may prevent your request from being processed* We rarely use the information in your earnings record for any purpose other than for determining your entitlement to also disclose information to another person or to another agency in accordance with approved routine uses which include but are not limited to the following 1.