Form SSA-7004, Request for Social Security Statement - also known as the SSA Form 7004 - is a form used to request information about the individual's earning history, estimates of their and their family members' eligibility for the Social Security benefits. It is also used for the estimation of taxes paid in Social Security.
The Social Security Administration (SSA) mails the Social Security Statement annually to workers aged 60 and to those who do not receive Social Security benefits three years prior to their birthday. If an individual files Form SSA-7004, the mailing schedule will change. The Social Security statements will be sent annually after the date the request was processed.
The most recent version of the Social Security Form SSA-7004 was issued by the SSA in April 2013. An SSA-7004 printable form is available below for download.
File Form SSA-7004-SM, Request for Earnings and Benefit Estimate Statement in order to have the SSA send you the following information: a record of your earnings and an estimate of your Social Security taxes, as well as estimates of benefits you and your family members may be eligible for.
Use Form SSA-7004-SM-OP1, Request for Social Security Statement, in order to request a Statement from the SSA electronic system.