TN 15 (09-92)

RS 01403.013 Employer Statement Forms, SSA-7011-F4, SSA-1002-F3, and SSA-1003-F3

A. POLICY — PRIMARY EVIDENCE

Forms SSA-7011-F4, SSA-1002-F3 and SSA-1003-F3 are primary evidence of wages if signed by the employer or an authorized person of the employer and based on the employer's records.

If an adequate record is available or enough facts are known by the employer so that he/she can state on the form that “not less than” a certain amount was paid to the individual, the signed statement is primary evidence.

B. POLICY — SECONDARY EVIDENCE

An estimate on any of these forms is secondary evidence since it is not based on the employer's record.

Any statement that is based solely on the individual's allegations about the amount received is secondary evidence.

C. REFERENCES

  • Requesting Employer Statements, RS 01403.035

  • Completion of Employer Statement Forms, RS 01403.037

  • Exhibit of Form SSA-7011-F4, Statement of Employer, RS 01403.110

  • Exhibit of Form SSA-1002-F3, Statement of Agricultural Employer (Years Prior to 1988), RS 01403.115

  • Exhibit of Form SSA-1003-F3, Statement of Agricultural Employer for Years 1988 and Later, RS 01403.120


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0301403013
RS 01403.013 - Employer Statement Forms, SSA-7011-F4, SSA-1002-F3, and SSA-1003-F3 - 02/15/1995
Batch run: 01/27/2009
Rev:02/15/1995