Supplemental Security Income Telephone Wage Reporting (SSITWR)

Supplemental Security Income
Telephone Wage Reporting Instructions
Recipients, deemors, and representative payees reporting a change in wages can
report total monthly wages to SSA by telephone. These instructions explain what
recipients, deemors, and representative payees need to do in order to use the SSA
phone system to report total monthly wages. Using the following charts to help
you calculate your monthly wages is voluntary. Recipients, deemors, and
representative payees who prefer not to report wages by telephone may use the
mobile wage reporting application, the online wage reporting tool on the my Social
Security website, or 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 Social Security office
for assistance.
When you should call to report monthly wages
Please report wages during the first six days of the month to help prevent an
incorrect SSI payment. You can choose which of the six days to call. If you miss
reporting during the six-day reporting period at the beginning of the month, you
can still report wages over the phone, via the mobile or internet application, or
through your local Social Security office.
Things you need to have before you report wages by telephone
 The caller’s Social Security number – this is the person actually calling to
report the wages
 The wage earner’s Social Security number - this is the person working
 The TOTAL amount of gross wages received for the entire month 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
for the entire month 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.
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, which is
the amount of take home pay on the paycheck, or the direct deposit amount to your
bank account. 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,
unused vacation, or any other reason, use a separate line to enter the pay date and
gross wages.
How Wage Earner is 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 received in the entire month.
Add together all gross wages in Box B for each line where you have wage
amounts. This is your total monthly wages. Put the total in Box C TOTAL.

Please double check that you only include all 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 the total gross wages received.
IMPORTANT:
• Please be sure to report wages from a quiet location, since background noise
may cause the report to fail.
• Each month you should report the total gross wages received in the
PREVIOUS month.
Remember, consistent and timely monthly wage reporting helps prevent SSI
overpayments and underpayments.

Call 1-866-772-0953 now to make your report.
Wage Reporting Reminder
You can now sign up for email or text reminders to report monthly wages for SSI
at www.socialsecurity.gov/ssiwagereporting/

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 and the associated instructions package is 0960-0715; expiration date
08/31/2019.

OMB 0960-0715

Supplemental Security Income
Wages for October 2018
Wages for OCTOBER
S

Days to report in NOVEMBER

M

T

W

T

F

S

S

M

T

1

2

3

4

5

6

7

8

9

10

11

12

13

4

5

6

14

15

16

17

18

19

20

11

12

21

22

23

24

25

26

27

18

28

29

30

31

25

W

T

F

S

1

2

3

7

8

9

10

13

14

15

16

17

19

20

21

22

23

24

26

27

28

29

30

Please report October’s wages during the first 6 days of November.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date October ___ , Gross
2018 Wages:
Paid:
Date October ___ , Gross
2018 Wages:
Paid:
Date October ___ , Gross
2018 Wages:
Paid:
Date October ___ , Gross
2018 Wages:
Paid:
Date October ___ , Gross
2018 Wages:
Paid:
Date October ___ , Gross
2018 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
OCTOBER 2018
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for November 2018
Wages for NOVEMBER
S

M

T

W

Days to report in DECEMBER

T

F

S

1

2

3

S

M

T

W

T

F

S
1

4

5

6

7

8

9

10

2

3

4

5

6

7

8

11

12

13

14

15

16

17

9

10

11

12

13

14

15

18

19

20

21

22

23

24

16

17

18

19

20

21

22

25

26

27

28

29

30

23

24

25

26

27

28

29

30

31

Please report November’s wages during the first 6 days of December.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date November ___ , Gross
2018 Wages:
Paid:
Date November ___ , Gross
2018 Wages:
Paid:
Date November ___ , Gross
2018 Wages:
Paid:
Date November ___ , Gross
2018 Wages:
Paid:
Date November ___ , Gross
2018 Wages:
Paid:
Date November ___ , Gross
2018 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
NOVEMBER 2018
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for December 2018
Wages for DECEMBER
S

M

T

W

T

F

Days to report in JANUARY 2019
S

S

M

1

T

W

T

F

S

1

2

3

4

5

2

3

4

5

6

7

8

6

7

8

9

10

11

12

9

10

11

12

13

14

15

13

14

15

16

17

18

19

16

17

18

19

20

21

22

20

21

22

23

24

25

26

23

24

25

26

27

28

29

27

28

29

30

31

30

31
Please report December’s wages during the first 6 days of January.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date December ___ , Gross
2018 Wages:
Paid:
Date December ___ , Gross
2018 Wages:
Paid:
Date December ___ , Gross
2018 Wages:
Paid:
Date December ___ , Gross
2018 Wages:
Paid:
Date December ___ , Gross
2018 Wages:
Paid:
Date December ___ , Gross
2018 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
DECEMBER 2018
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for January 2019
Wages for JANUARY 2019
S

M

Days to report in FEBRUARY

T

W

T

F

S

1

2

3

4

5

S

M

T

W

T

F

S

1

2

6

7

8

9

10

11

12

3

4

5

6

7

8

9

13

14

15

16

17

18

19

10

11

12

13

14

15

16

20

21

22

23

24

25

26

17

18

19

20

21

22

23

27

28

29

30

31

24

25

26

27

28

Please report January’s wages during the first 6 days of February.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date January
Paid:

___ ,
2019

Gross
Wages:

$

Date January
Paid:

___ ,
2019

Gross
Wages:

$

Date January
Paid:

___ ,
2019

Gross
Wages:

$

Date January
Paid:

___ ,
2019

Gross
Wages:

$

Date January
Paid:

___ ,
2019

Gross
Wages:

$

Date January
Paid:

___ ,
2019

Gross
Wages:

$

BOX C

TOTAL
Gross Wages

$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
JANUARY 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for February 2019
Wages for FEBRUARY
S

M

T

W

T

Days to report in MARCH

F

S

1

2

S

M

T

W

T

F

S

1

2

3

4

5

6

7

8

9

3

4

5

6

7

8

9

10

11

12

13

14

15

16

10

11

12

13

14

15

16

17

18

19

20

21

22

23

17

18

19

20

21

22

23

24

25

26

27

28

24

25

26

27

28

29

30

31
Please report February’s wages during the first 6 days of March.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date February ___, Gross
2019 Wages:
Paid:
Date February ___, Gross
2019 Wages:
Paid:
Date February ___, Gross
2019 Wages:
Paid:
Date February ___, Gross
2019 Wages:
Paid:
Date February ___, Gross
2019 Wages:
Paid:
Date February ___, Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
FEBRUARY 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for March 2019
Wages for MARCH
S

M

T

W

T

Days to report in APRIL

F

S

1

2

S

M

T

W

T

F

S

1

2

3

4

5

6

3

4

5

6

7

8

9

7

8

9

10

11

12

13

10

11

12

13

14

15

16

14

15

16

17

18

19

20

17

18

19

20

21

22

23

21

22

23

24

25

26

27

24

25

26

27

28

29

30

28

29

30

31
Please report March’s wages during the first 6 days of April.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date March ___ , Gross
2019 Wages:
Paid:
Date March ___ , Gross
2019 Wages:
Paid:
Date March ___ , Gross
2019 Wages:
Paid:
Date March ___ , Gross
2019 Wages:
Paid:
Date March ___ , Gross
2019 Wages:
Paid:
Date March ___ , Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
MARCH 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for April 2019
Wages for APRIL
S

Days to report in MAY

M

T

W

T

F

S

S

M

1

2

3

4

5

6

7

8

9

10

11

12

13

5

6

14

15

16

17

18

19

20

12

21

22

23

24

25

26

27

28

29

30

T

W

T

F

S

1

2

3

4

7

8

9

10

11

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Please report April’s wages during the first 6 days of May.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date April ___ , Gross
2019 Wages:
Paid:
Date April ___ , Gross
2019 Wages:
Paid:
Date April ___ , Gross
2019 Wages:
Paid:
Date April ___ , Gross
2019 Wages:
Paid:
Date April ___ , Gross
2019 Wages:
Paid:
Date April ___ , Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
APRIL 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for May 2019
Wages for MAY
S

M

T

Days to report in JUNE

W

T

F

S

1

2

3

4

S

M

T

W

T

F

S
1

5

6

7

8

9

10

11

2

3

4

5

6

7

8

12

13

14

15

16

17

18

9

10

11

12

13

14

15

19

20

21

22

23

24

25

16

17

18

19

20

21

22

26

27

28

29

31

23

24

25

26

27

28

29

30
Please report May’s wages during the first 6 days of June.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date May ___ , Gross
2019 Wages:
Paid:
Date May ___ , Gross
2019 Wages:
Paid:
Date May ___ , Gross
2019 Wages:
Paid:
Date May ___ , Gross
2019 Wages:
Paid:
Date May ___ , Gross
2019 Wages:
Paid:
Date May ___ , Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
MAY 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for June 2019
Wages for JUNE
S

M

T

W

T

Days to report in JULY
F

S

S

1

M

T

W

T

F

S

1

2

3

4

5

6

2

3

4

5

6

7

8

7

8

9

10

11

12

13

9

10

11

12

13

14

15

14

15

16

17

18

19

20

16

17

18

19

20

21

22

21

22

23

24

25

26

27

23

24

25

26

27

28

29

28

29

30

31

30
Please report June’s wages during the first 6 days of July.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date June ___ ,
2019
Paid:
Date June ___ ,
2019
Paid:
Date June ___ ,
2019
Paid:

Gross
Wages:

$

Gross
Wages:

$

Gross
Wages:

$

Date June ___ ,
2019
Paid:
Date June ___ ,
2019
Paid:
Date June ___ ,
2019
Paid:

Gross
Wages:

$

Gross
Wages:

$

Gross
Wages:

$

TOTAL
Gross Wages

$

BOX C

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
JUNE 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for July 2019
Wages for JULY
S

Days to report in AUGUST

M

T

W

T

F

S

S

M

T

1

2

3

4

5

6

7

8

9

10

11

12

13

4

5

6

14

15

16

17

18

19

20

11

12

21

22

23

24

25

26

27

18

28

29

30

31

25

W

T

F

S

1

2

3

7

8

9

10

13

14

15

16

17

19

20

21

22

23

24

26

27

28

29

30

31

Please report July’s wages during the first 6 days of August.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date July ___ , Gross
2019 Wages:
Paid:
Date July ___ , Gross
2019 Wages:
Paid:
Date July ___ , Gross
2019 Wages:
Paid:
Date July ___ , Gross
2019 Wages:
Paid:
Date July ___ , Gross
2019 Wages:
Paid:
Date July ___ , Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
JULY 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for August 2019
Wages for AUGUST
S

M

T

W

Days to report in SEPTEMBER

T

F

S

S

M

T

W

T

F

S

1

2

3

1

2

3

4

5

6

7

4

5

6

7

8

9

10

8

9

10

11

12

13

14

11

12

13

14

15

16

17

15

16

17

18

19

20

21

18

19

20

21

22

23

24

22

23

24

25

26

27

28

25

26

27

28

29

30

31

29

30

Please report August’s wages during the first 6 days of September.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date August ___ , Gross
2019 Wages:
Paid:
Date August ___ , Gross
2019 Wages:
Paid:
Date August ___ , Gross
2019 Wages:
Paid:
Date August ___ , Gross
2019 Wages:
Paid:
Date August ___ , Gross
2019 Wages:
Paid:
Date August ___ , Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
AUGUST 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

OMB 0960-0715

Supplemental Security Income
Wages for September 2019
Wages for SEPTEMBER

Days to report in OCTOBER

S

M

T

W

T

F

S

S

1

2

3

4

5

6

7

8

9

10

11

12

13

14

6

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

M

T

W

T

F

S

1

2

3

4

5

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Please report September’s wages during the first 6 days of October.

BOX A
Line
1
Line
2
Line
3
Line
4
Line
5
Line
6

BOX B

Date September ___ , Gross
2019 Wages:
Paid:
Date September ___ , Gross
2019 Wages:
Paid:
Date September ___ , Gross
2019 Wages:
Paid:
Date September ___ , Gross
2019 Wages:
Paid:
Date September ___ , Gross
2019 Wages:
Paid:
Date September ___ , Gross
2019 Wages:
Paid:

BOX C

TOTAL
Gross Wages

$
$
$
$
$
$
$

,.
,.
,.
,.
,.
,.
,.

Use the TOTAL Gross Wages from BOX C when you report wages for
September 2019
Call 1-866-772-0953 now to make your report
KEEP PAY SLIPS AND THIS FORM FOR YOUR RECORDS

SSA will insert the following revised Privacy Act Statement into the form as soon
as possible:
Privacy Act Statement
Collection and Use of Personal Information
Sections 205(a) and 1631(d) of the Social Security Act, as amended, allow us to collect this
information. Furnishing us this information is voluntary. However, failing to provide all or part
of the information may prevent us from making an accurate and timely decision on eligibility for
Supplemental Security Income (SSI) benefits.
We will use the information you provide to make a determination of eligibility for SSI benefits.
We may also share your information for the following purposes, called routine uses:


To third party contacts such as private collection agencies and credit reporting agencies
under contract with the Social Security Administration (SSA) and State motor vehicle
agencies for the purpose of their assisting SSA in recovering overpayments; and



To contractors and other Federal agencies, as necessary, for the purpose of assisting SSA
in the efficient administration of its programs.

In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notices
(SORN) 60-0089, entitled Claims Folders System, as published in the Federal Register (FR) on
April 01, 2003, at 68 FR 15784 and 60-0103, entitled Supplemental Security Income Record and
Special Veterans Benefits, as published in the FR on January 11, 2006, at 71 FR 1830.
Additional information, and a full listing of all of our SORNs, is available on our website at
www.ssa.gov/privacy.