Download:
pdf |
pdfSupplemental Security Income
Telephone Wage Report Instructions
Beneficiaries, deemors and representative payees reporting a change in wages can
report their monthly wages to SSA by telephone. These instructions explain what
beneficiaries, deemors, and representative payees need to do in order to use the
SSA phone system to report monthly wages. Using the following charts to help
you calculate your monthly wages is voluntary. Beneficiaries, deemors and
representative payees who would rather not report wages by telephone can use
traditional reporting methods such as mailing or bringing paystubs into their local
Social Security office. Monthly telephone reporters who experience technical
difficulties should contact their local field office for assistance.
When you should call to report wages
Report wages during the first 6 days of the month. You can choose which of the 6
days to call. But, you will not be able to report wages using the special 800
number after the sixth day of the month. If you miss reporting wages during the
first 6 days of the month, report the wages to your local Social Security office.
Things you need to have before you to report wages by telephone
The Social Security number of the person who is reporting wages (the caller)
The Social Security number of the wage earner
The TOTAL amount of gross wages received by the wage earner. Gross wages
are the amount of pay before taxes and other deductions
The caller’s name as it appears on their Social Security card
How to figure the total wages for each month
Fill in the blanks on the attached worksheets. Use your worksheet to report wages
when you call the 800 number.
Who is the Wage Earner?
A wage earner is the person who is working and receiving wages or payment for
working. You are the wage earner if you are working and you are reporting your
own wages. If you are calling to report someone else’s wages, then the wage
earner is the person whose wages you are reporting.
How to fill-in the worksheet
Date Paid
Use Box A to show the date paid (payday).
Date Paid is the date (Month, Day, Year) the wage earner is paid (pay day).
Gross Wages
Use Box B to show the gross amount of wages.
Enter dollars and cents ($ X,XXX. cc).
Use the wage earner’s pay stub to find the gross wages. Gross wages are the
amount of pay before taxes and other deductions. Do not enter net wages, the
amount of take home pay on the paycheck, or the direct deposit amount to your
bank. Do not enter the total wages for the year, also called the year-to-date (YTD)
amount.
Use a Separate Line for Each Pay
You should fill-in a line for each pay date in a month.
If the wage earner is paid 2 times a month, you should fill-in Line 1 and Line 2.
If the wage earner is paid 3 times a month, you should fill-in Line 1, Line 2 and
Line 3.
If the wage earner is paid 4 times a month, you should fill-in Line 1, Line 2,
Line 3, and Line 4.
If the wage earner is paid 5 times a month, you should fill-in Line 1, Line 2,
Line 3, Line 4 and Line 5.
If the wage earner gets an extra check for special pay such as an award, bonus, or
unused vacation, or any other reason, use a separate line to enter the pay date and
gross wages.
How Wage Earner Paid
Paid Weekly
Paid Bi-Weekly (Every 2 Weeks)
Paid Bi-Monthly
Paid Monthly
Number of Pays a Month
4 Pays or 5 Pays
2 or 3 Pays
2 Pays
1 Pay
Total Gross Wages
Use Box C to enter the total amount of gross wages.
Add together all gross wages in Box B for each line where you have wage
amounts. This is your total. Put the total in Box C TOTAL.
Please double check that you only include dates and amounts that you received in
the month shown at the top of the page.
You are now ready to call in and report total gross wages received.
IMPORTANT: Please be sure to report wages from a quiet location, since
background noise may cause the report to fail.
Remember, consistent monthly wage reporting helps prevent SSI
overpayments and underpayments.
Call 1-866-772-0953 now and make your report.
Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. §3507, as
amended by section 2 of the Paperwork Reduction Act of 1995. You do not need
to answer these questions unless we display a valid Office of Management and
Budget control number. We estimate that it will take about 5 minutes to read the
instructions, gather the facts, and answer the questions.
You may send comments on our time estimate above to: SSA, 6401 Security Blvd.,
Baltimore, MD 21235-6401. Send only comments relating to our time estimate to
this address, not the completed report.
The OMB control number for the Supplemental Security Income Telephone Wage
Reporting System and the associated instructions package is 0960-0715; expiration
date 07/31/2013.
OMB 0960-0715
Supplemental Security Income
Wages for October 2012
Wages for OCTOBER
S
M
1
7
14
21
28
T
2
8
15
22
29
W
3
9
16
23
30
T
4
10
17
24
31
11
18
25
F
5
12
19
26
Days to report in NOVEMBER
S
6
13
20
27
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
4
M
5
T
W
T
F
S
1
2
3
6
BOX B
Date October ___ ,
2012
Paid:
Date October ___ ,
2012
Paid:
Date October ___ ,
2012
Paid:
Date October ___ ,
2012
Paid:
Gross
Wages:
$
Gross
Wages:
$
Gross
Wages:
$
Gross
Wages:
$
Date October ___ , Gross
2012 Wages:
Paid:
Date October ___ , Gross
2012 Wages:
Paid:
BOX C
S
TOTAL
Gross Wages
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
OCTOBER 2012
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for November 2012
Wages for NOVEMBER
S
M
T
W
Days to report in DECEMBER
T
1
F
2
S
3
S
2
4
5
6
7
8
9
10
11
18
25
12
19
26
13
20
27
14
21
28
15
22
29
16
23
30
17
24
W
T
F
S
3
4
5
6
BOX B
Date November ___ ,
2012
Paid:
Date November ___ ,
2012
Paid:
Date November ___ ,
2012
Paid:
Date November ___ ,
2012
Paid:
Gross
Wages:
$
Gross
Wages:
$
Gross
Wages:
$
Gross
Wages:
$
Date November ___ , Gross
2012 Wages:
Paid:
Date November ___ , Gross
2012 Wages:
Paid:
BOX C
T
1
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
M
TOTAL
Gross Wages
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
NOVEMBER 2012
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for December 2012
Wages for DECEMBER
S
M
T
W
T
F
Days to report in JANUARY,
2013
S
2
3
4
5
6
7
1
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
6
M
T
W
T
F
S
1
2
3
4
5
BOX B
Date December ___ , Gross
2012 Wages:
Paid:
Date December ___ , Gross
2012 Wages:
Paid:
Date December ___ , Gross
2012 Wages:
Paid:
Date December ___ , Gross
2012 Wages:
Paid:
Date December ___ , Gross
2012 Wages:
Paid:
Date December ___ , Gross
2012 Wages:
Paid:
BOX C
S
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
DECEMBER 2012
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for January 2013
Wages for JANUARY, 2013
S
M
T
W
T
F
Days to report in FEBRUARY
S
S
1
2
3
4
5
6
7
8
9
10
11
12
13
20
27
14
21
28
15
22
29
16
23
30
17
24
31
18
25
19
26
3
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
4
T
5
W
T
F
S
1
2
6
BOX B
Date January
Paid:
___ ,
2013
Gross
Wages:
$
Date January
Paid:
___ ,
2013
Gross
Wages:
$
Date January
Paid:
___ ,
2013
Gross
Wages:
$
Date January
Paid:
___ ,
2013
Gross
Wages:
$
Date January
Paid:
___ ,
2013
Gross
Wages:
$
Date January
Paid:
___ ,
2013
Gross
Wages:
$
BOX C
M
TOTAL Gross
Wages
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
JANUARY 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for February 2013
Wages for FEBRUARY
S
M
T
W
T
F
Days to report in MARCH
S
S
3
4
5
6
7
1
8
2
9
10
11
12
13
14
15
16
17
24
18
25
19
26
20
27
21
28
22
23
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
4
T
5
W
T
F
S
1
2
6
BOX B
Date February ___, Gross
2013 Wages:
Paid:
Date February ___, Gross
2013 Wages:
Paid:
Date February ___, Gross
2013 Wages:
Paid:
Date February ___, Gross
2013 Wages:
Paid:
Date February ___, Gross
2013 Wages:
Paid:
Date February ___, Gross
2013 Wages:
Paid:
BOX C
3
M
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
FEBRUARY 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for March 2013
Wages for MARCH
S
M
T
W
T
Days to report in APRIL
F
S
S
1
2
3
4
5
6
7
8
9
10
17
24
11
18
25
12
19
26
13
20
27
14
21
28
15
22
29
16
23
30
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
T
W
T
F
S
1
2
3
4
5
6
BOX B
Date March ___ , Gross
2013 Wages:
Paid:
Date March ___ , Gross
2013 Wages:
Paid:
Date March ___ , Gross
2013 Wages:
Paid:
Date March ___ , Gross
2013 Wages:
Paid:
Date March ___ , Gross
2013 Wages:
Paid:
Date March ___ , Gross
2013 Wages:
Paid:
BOX C
M
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
MARCH 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for April 2013
Wages for APRIL
S
M
T
W
T
Days to report in MAY
F
S
1
2
3
4
5
6
7
8
9
10
11
12
13
14
21
28
15
22
29
16
23
30
17
24
18
25
19
26
20
27
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
S
T
W
T
F
S
1
2
3
4
6
BOX B
Date April ___ , Gross
2013 Wages:
Paid:
Date April ___ , Gross
2013 Wages:
Paid:
Date April ___ , Gross
2013 Wages:
Paid:
Date April ___ , Gross
2013 Wages:
Paid:
Date April ___ , Gross
2013 Wages:
Paid:
Date April ___ , Gross
2013 Wages:
Paid:
BOX C
5
M
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
APRIL 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for May 2013
Wages for MAY
S
M
T
W
T
Days to report in JUNE
F
S
1
2
3
4
5
6
7
8
9
10
11
12
19
26
13
20
27
14
21
28
15
22
29
16
23
30
17
24
31
18
25
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
S
T
W
T
F
S
1
2
3
4
5
6
BOX B
Date May ___ , Gross
2013 Wages:
Paid:
Date May ___ , Gross
2013 Wages:
Paid:
Date May ___ , Gross
2013 Wages:
Paid:
Date May ___ , Gross
2013 Wages:
Paid:
Date May ___ , Gross
2013 Wages:
Paid:
Date May ___ , Gross
2013 Wages:
Paid:
BOX C
M
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
MAY 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for June 2013
Wages for JUNE
S
M
2
9
16
23
30
T
3
10
17
24
4
11
18
25
W
5
12
19
26
T
6
13
20
27
Days to report in JULY
F
7
14
21
28
S
1
8
15
22
29
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
M
T
W
T
F
S
1
2
3
4
5
6
BOX B
Date June ___ , Gross
2013 Wages:
Paid:
Date June ___ , Gross
2013 Wages:
Paid:
Date June ___ , Gross
2013 Wages:
Paid:
Date June ___ , Gross
2013 Wages:
Paid:
Date June ___ , Gross
2013 Wages:
Paid:
Date June ___ , Gross
2013 Wages:
Paid:
BOX C
S
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
JUNE 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for July 2013
Wages for JULY
S
M
T
W
T
Days to report in AUGUST
F
S
7
1
8
2
9
3
10
4
11
5
12
6
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
4
M
5
T
W
T
F
S
1
2
3
6
BOX B
Date July ___ , Gross
2013 Wages:
Paid:
Date July ___ , Gross
2013 Wages:
Paid:
Date July ___ , Gross
2013 Wages:
Paid:
Date July ___ , Gross
2013 Wages:
Paid:
Date July ___ , Gross
2013 Wages:
Paid:
Date July ___ , Gross
2013 Wages:
Paid:
BOX C
S
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
JULY 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for August 2013
Wages for AUGUST
S
M
T
W
T
Days to report in SEPTEMBER
F
S
1
2
3
4
5
6
7
8
9
10
11
18
25
12
19
26
13
20
27
14
21
28
15
22
29
16
23
30
17
24
31
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
M
T
W
T
F
1
2
3
4
5
6
S
BOX B
Date August ___ , Gross
2013 Wages:
Paid:
Date August ___ , Gross
2013 Wages:
Paid:
Date August ___ , Gross
2013 Wages:
Paid:
Date August ___ , Gross
2013 Wages:
Paid:
Date August ___ , Gross
2013 Wages:
Paid:
Date August ___ , Gross
2013 Wages:
Paid:
BOX C
S
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
AUGUST 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
Supplemental Security Income
Wages for September 2013
Wages for SEPTEMBER
S
1
8
15
22
29
M
T
2
9
16
23
30
3
10
17
24
W
T
4
11
18
25
5
12
19
26
F
Days to report in OCTOBER
S
6
13
20
27
S
7
14
21
28
BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6
T
W
T
F
S
1
2
3
4
5
6
BOX B
Date September ___ , Gross
2013 Wages:
Paid:
Date September ___ , Gross
2013 Wages:
Paid:
Date September ___ , Gross
2013 Wages:
Paid:
Date September ___ , Gross
2013 Wages:
Paid:
Date September ___ , Gross
2013 Wages:
Paid:
Date September ___ , Gross
2013 Wages:
Paid:
BOX C
M
TOTAL
Gross Wages
$
$
$
$
$
$
$
,.
,.
,.
,.
,.
,.
,.
Use the TOTAL Gross Wages from BOX C when you report wages for
September 2013
Call 1-866-772-0953 now and make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS
| File Type | application/pdf |
| File Title | Supplemental Security Income Telephone Wage Report Worksheet |
| Author | Taz Wicks-Simmons |
| File Modified | 2012-05-23 |
| File Created | 2012-05-23 |