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Social Security Administration Earnings Forms

Two PDF links are available below. Both are identical and contain four (4) pages. The first link is a blank form to submit to the Social Security Administration. The second link is an example of a completed form to show the items that need to be filled in.

Simply complete the form as indicated. The individual for whom wages are being requested will need to sign and date the form. Social Security must have the ORIGINAL signature, not a fax or a photocopy. Mail the completed form to the Social Security Administration office in Baltimore, MD. The addresses are listed at the bottom of Page 2. You may call the Social Security Administration at 1-800-772-1213 for assistance if necessary.

We understand that the turn around time to receive the requested information is 4-6 weeks.

If you have any questions, please contact our office.

Request for Social Security Earnings Information (PDF)


Request for Social Security Earnings Information example (PDF)




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