A social security statement request form is a document individuals use to request information about their earning history and reveals how much they will get in benefits once they retire or become disabled.
This document is also known as:
- Form SSA-7004
- Request for Earnings and Benefit Estimate Statement
- Social Security Earnings Statement Form
- Social Security Statement Form
- Request For Social Security Statement
What is a Social Security Statement Request Form?
A social security statement request form is used to provide an individual with an estimation of their past earnings, the amount they’ve paid in Social Security taxes, and the social security benefits they would collect. The statement can also include information on the benefits their family members would receive.
You can get a social security estimated benefits statement request form by:
- Going to your local social security office
- Requesting a copy through the phone
- Requesting a copy online through your My Social Security account
Anyone who has a Social Security Number (SSN) and is 25 or older can file the request.
At the end of the form, you can choose to have the social security statement request sent to you or someone else, such as your accountant.
How to Write a Social Security Statement Request
When you fill in Form SSA-7004, you can follow the below steps or use our form builder to guide you through the steps with helpful prompts.
- For Parts 1 to 5, fill in the form as indicated.
- For Part 6, enter your actual earnings for the previous year. Then, show the amount you think you’ll earn this year. Both figures include wages as well as total self-employment income.
- For Part 7, type in how old you think you’ll be when you stop working. If you’re not sure, just include an estimate (i.e., retirement age). You can only show one age, not a range of ages.
- For Part 8, enter the average yearly amount that you think you’ll earn before you stop working. Include scheduled pay or performance bonuses or increases, but don’t include increases in the cost of living.
- If you think you’ll earn much less or more in the future due to career changes, leaving the workforce, promotions, or other reasons, enter the amount that most accurately reflects your future average yearly earnings.
- If you don’t expect any noticeable changes, you should type in the same amount you’re earning now (the same amount as in Block 6).
- For Part 9, indicate whether you want the statement to be sent to you or someone else. If you want it sent to someone else, write your name followed by “c/o” and the address and name of the person.
- You may want the yearly statement to be sent to someone else if you have an accountant or pension plan.
What to Include in a Social Security Statement Request Form
After filling in the fields on your social security request, make sure you’ve included the following:
- Full name
- SSN
- Date of birth
- Other SSNs you have used
- Sex
- Last year’s actual earnings
- This year’s estimated earnings
- The age you plan to stop working
- Future average yearly earnings
FAQs/Related questions
You can request a copy of your social security statement by mailing your SSA-7004 form to the below mailing address: Social Security Administration Wilkes Barre Direct Operations Center P.O. Box 7004 Wilkes Barre, PA 18767-7004 Social Security doesn’t automatically send out benefits statements unless you’re 60 years of age or older. In that case, they send a benefit statement three months before your birth month. For people under 60, you will have to request a benefits statement by either: Here is a sample of a social security statement request form: Download: Adobe PDF
How do I request a copy of my Social Security Statement?
When does Social Security send out benefit statements?
Sample Social Security Statement Request Form
