TN 11 (11-97)

GN 05010.505 Form SSA-1042S


The SSA-1042S consists of three parts:

  • a benefit statement part which is the same as that on the SSA-1099, except as shown in GN 05010.505B.;

  • an explanation of the form and the items in the benefit portion of the form; and

  • an explanation of computer matching programs.

The SSA-1042S is revised each year to show the tax year for which it is issued and to include any changes which have been made since the prior year.


The following list shows information shown on the SSA-1042S in addition to that shown on the SSA-1099 and expands on the explanation of the material included under other items which are common to both forms.

1. Box 3, Benefits

a. Paid by check or direct deposit

This shows all payments made to the beneficiary, both taxable and nontaxable income.

b. Deductions for work or other adjustments

This includes any amounts withheld for work or other deductions or to recover overpayments. Where a benefit which was subject to the nonresident alien tax was withheld to recover an overpayment from which alien tax was withheld, the amount shown includes the administrative adjustment (as explained in GN 05010.200B.3.)

c. Amount withheld for taxes

This is the net amount of nonresident alien tax withheld (as shown in Box 9).

2. Box 4, Benefits Repaid to SSA

The amount shown in this box and in the description under “Deductions for work or other adjustments” includes the administrative adjustment in overpayment cases involving alien tax withholding.

3. Box 6, Rate of Tax

This shows the nonresident alien tax withholding rate in effect at the time the annual statement was prepared. This rate is shown even if the beneficiary was subject to more than one rate during that year. The rate applies to 85 percent of the benefit amount.

4. Box 7, Amount of Tax Withheld

This shows the total amount of nonresident alien tax withheld in the statement year.

5. Box 8, Amount of Tax Refunded

This shows the amount of nonresident alien tax refunded to the beneficiary in the statement year. The refund may have been paid to the beneficiary or used to repay an overpayment.

6. Box 9, Net Tax Withheld (Box 7 Minus Box 8)

This shows the difference between Box 7 and Box 8. Due to rounding and other factors, the amount shown is not necessarily the same as the amount derived by applying the tax rate to the amount in Box 5.

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GN 05010.505 - Form SSA-1042S - 11/13/1997
Batch run: 11/13/1997