TN 7 (07-89)

RM 02270.025 How to Prepare Form SSA-4058, Wage Report Fact Sheet and Form SSA-4059, Wage Report Continuation Sheet

A. Introduction

Preparation of form SSA-4058 starts at beginning of investigation.

B. Exhibit

SSA-4059

C. Procedure

KEY: Field #is number of field in exhibits above. Complete by writing:

1. SSA-4058

  1. 1. 

    EIN

  2. 2. 

    current date

  3. 3. 

    employer's name

  4. 4. 

    periods involved

  5. 5. 

    stated problem

  6. 6. 

    your findings as a result of scouting

  7. 7. 

    resolution you reached

  8. 8. 

    status/follow-up report you furnished R/O

  9. 9. 

    your name.

2. SSA-4059

  1. 1. 

    date of your entry

  2. 2. 

    any information related to case.

NOTE: Date all pertinent information on either form.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0102270025
RM 02270.025 - How to Prepare Form SSA-4058, Wage Report Fact Sheet and Form SSA-4059, Wage Report Continuation Sheet - 09/28/1994
Batch run: 09/28/1994
Rev:09/28/1994