SSA-7008

Request For Corrections Of Earnings Record

Download and Print the SSA-7008

Request may not be processed if the form is incomplete or illegible.

I have examined your statement (or record) of my Social Security earnings and it is not correct. I am providing the following information and accompanying evidence so that you can correct my record.
1. Print your name (First Name, Middle Initial, Last Name)
2. Enter your date of birth (Month, Day, Year)
3. Print your name as shown on your Social Security number card
4. Print any other name used in your work. (If you have used no other name enter "None.")
5. (a) Enter your Social Security number
- -
5. (b)
Enter any other Social Security number(s) used by you or your employer to report your wages or self-employment. If none, check "None."
(1)
None
(2)
- -
(3)
- -
6. IF NECESSARY, SSA MAY DISCLOSE MY NAME TO MY EMPLOYERS: (Without permission to use your name, SSA cannot make a thorough investigation.)
}
YES
NO
}
If you disagree with wages reported to your earnings record, complete Item 7.
}
If you disagree with self-employment income recorded on your earnings record, go to Item 8.

And much more...