Statement of Agricultural Employer (Years Prior to 1988; 1988 and Later)

Justification for Non-Substantive Changes for Forms SSA-1002, SSA-1003

Statement of Agricultural Employer (Years Prior to 1988; 1988 and Later)

20 CFR 404.702,404.709, 404.802, and 404.1056

OMB No. 0960-0036

Background

The Social Security Administration (SSA) uses Forms SSA-1002 and SSA-1003 to collect wage information of an agricultural worker if they believe their employers either (1) did not report their wages, or (2) reported incorrect wage amounts for agricultural wages prior to 1988. Currently, the paper and PDF versions of these forms include a signature requirement.

SSA recently reassessed the need for the respondent’s signature on these forms and determined that we no longer require it. Therefore, we are removing the signature requirements from these forms.

While we will leave a name block on the forms, we will not require a wet signature. The respondent will be able to type in their name without the requirement to print the form and sign it.

Revision to the Information Collection

• Change #1: SSA is removing the signature requirements from Forms SSA-1002 and SSA-1003.

Justification #1: We reassessed the need for a wet signature on these forms and determined we no longer require it. Therefore, we will no longer ask respondents to sign these forms prior to SSA submission.

• Change #2:  In both Forms SSA-1002 and SSA-1003, we are replacing the Penalty of Perjury Statement with a Penalty of Perjury Warning: Anyone who knowingly makes or causes to be made a false statement or representation of material fact for use in determining a payment under the Social Security Act, or knowingly conceals or fails to disclose an event with an intent to affect an initial or continued right to payment, or submits or causes to be submitted any false statement or document knowing the same to contain any misrepresentation of material fact, commits a crime punishable under Federal law by fine, imprisonment, or both, and may be subject to administrative sanctions.

Justification #2:  SSA is removing the Penalty of Perjury Statement since a signature is no longer required. SSA is replacing the Penalty of Perjury Statement with a Penalty of Perjury Warning to maintain the intent of the Statement.

• Change #3:  We are removing gender specific language from these forms.

Justification #3: To comply with the Inclusive Language Initiative, we replaced gender specific language with gender neutral language.

After OMB approves the signature removal for these forms, we will implement the new versions of these forms that clarify that we no longer require a signature by removing the signature block. The new version of the form will provide space to collect the name and title of the individual completing the form.

This action will not affect the public reporting burden.