Washington Authorization for Wage and Employment Information with Revocation of Any Previous Authorizations

State:
Multi-State
Control #:
US-PI-0243
Format:
Word; 
Rich Text
Instant download

Description

This form is used to inform the plaintiff's employer that an attorney has been retained by plaintiff and that plaintiff authorizes the release to attorney of employee's records.

How to fill out Authorization For Wage And Employment Information With Revocation Of Any Previous Authorizations?

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FAQ

Burden to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401.

SSA uses the form SSA-8240 to collect authorization from the public to obtain their wage and employment information from payroll data providers to determine program eligibility and payment amounts.

The term "payroll data provider" means payroll providers, wage verification companies, and other commercial or non-commercial entities that collect and maintain data regarding employment and wages, without regard to whether the entity provides such data for a fee or without cost.

Section 1184 of the Social Security Act (Act) authorizes the Social Security Administration (SSA) to enter into information exchanges with payroll data providers. SSA will use my authorization to obtain wage and employment information from payroll data providers.

You can upload documents by using the Send Response for Individual Case link on the Electronic Records Express Home page. The upload function is also available while accessing a claimant's electronic folder through the Access Claimant's Electronic Folder link.

SSA uses the form SSA-8240 to collect authorization from the public to obtain their wage and employment information from payroll data providers to determine program eligibility and payment amounts.

YOU MUST SIGN, DATE, AND RETURN THE ENGLISH VERSION OF THE SSA-827 TO YOUR LOCAL SOCIAL SECURITY OFFICE TO HAVE YOUR DISABILITY CLAIM PROCESSED.

If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you.

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Washington Authorization for Wage and Employment Information with Revocation of Any Previous Authorizations