TN 2 (10-19)

RM 02226.010 Instructions for Completing the Electronic Form SSA-4130

A. Policy on the Form SSA-4130

When the electronic correction tools, ICOR and RCOR, does not allow an adjustment to an individual or employer record, OEIO personnel can use the electronic REAP Form SSA-4130 (Interoffice Itemized Adjustments) to make the adjustment. The electronic Form SSA-4130 enables OEIO personnel to correct wages, tips or Medicare amounts previously reported on a Form W-2. This form corrects earnings on an individual basis in the earnings suspense file (ESF). It may adjust one or more individual items.

B. Instructions for completing Form SSA-4130

Division of Earnings and Business Services (DEBS) personnel will use the instructions in this section to complete the individual fields on the electronic Form SSA-4130 (Interoffice Itemized Adjustments) using the chart below:

*Indicates manadatory field

Field …

How to Complete …

Number of pages:

Complete one page or multi-pages report (as applicable)

NOTE: One page has eight (8) entries only. If multi-pages are required, one page is completed and submitted at a time. Once a page is completed, click the "Show Totals" button and the totals will appear. Insert the Earnings Case Management System (ECMS) REAP Totals into Reconcilition Image Managment System (RIMS) (for each form completed). Once the "Submit" buton is selected, a blank form will appear. Continue this process until you have completed the number of pages required for the case.

*Types of Modification (TOM):

Select an option:

  • 06-08 – all increases;

  • 09-11 – all decreases;

  • 12-14 – mixed;

*Employment Code

 

Select an employment code:

  • Agriculture,

  • Household, ;

  • Military,

  • Regular

*SSN

Enter Social Security Number (9 digits) for each item to be listed.

NOTE: If no SSN, enter all zeroes (000-00-0000).

*Initials (*1st and 2nd )

Enter first initials of each individual; if no middle initial, leave blank.

*Employee Last Name

Enter last name of each individual: If no last name exists, then enter “None” in the Last Name field.

QTR

Leave blank

*Wages, Tips & Medicare Decrease/Increase

Enter amount of Wage adjustment:

  • If adjustment is a decrease, enter a negative sign (-) before the money amount

NOTE: When using type of modification (TOM) code 12-14, show all decreases on one line and all increases on the next line for the same SSN.

  • Enter amount of Tips adjustment (if applicable)

NOTE: When using TOM code 12-14, show all decreases on one line and all increases on the next line for the same SSN.

  • Enter amount of Medicare adjustment

NOTE: When using TOM code 12-14, show all decreases on one line and all increases on the next line for the same SSN.

Other

Additional remarks (if applicable)

*Show Totals

*Click the "Show Totals" button and the totals of the completed form will appear.

Note: Review totals for accuracy. If the totals are incorrect, select the "Reset" button to re-enter the wages.

*Insert the ECMS REAP Totals into RIMS for each form completed.

*Submit

.

Click the "Submit" button to send the form to WBDOC for processing


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0102226010
RM 02226.010 - Instructions for Completing the Electronic Form SSA-4130 - 10/18/2019
Batch run: 10/18/2019
Rev:10/18/2019