TN 14 (08-92)

RS 01403.059 Statement of Claimant and Persons Who Know About Employment and Wages


1. List of Sources

Sources include:

  1. supervisors;

  2. foremen;

  3. fellow employees;

  4. banks or others who cashed paychecks on a regular basis;

  5. employment agencies;

  6. union officials and representatives; and

  7. others who establish a sufficient basis for their knowledge.

2. Probative Value

This depends on credibility and lack of a motive for making a wrong statement. Statements only establishing employment are of greater probative value if they corroborate other statements establishing amount(s) of wages (tips).


1. Development

Obtain a signed (and dated) statement showing:

  1. the person's relationship to the employee;

  2. the evidence/basis for the declarant's knowledge for the facts /estimates declared;

  3. name of employer, place of employment, and kind of work performed;

  4. rate of pay per each period of work;

  5. if rate is not known, an estimate of earnings for each period worked which may include a “not less than” estimate;

  6. the declarant's understanding that the information furnished is to be used by SSA to establish wages for the employee.

2. Other Documentation

Complete a RC:

  1. to explain any doubt as to the credibility of the declarant's statement, only if there is such doubt; and

  2. if an employer refuses to complete a signed statement but is otherwise willing to furnish oral information.

3. Migrant Farm Workers

Follow instructions in RS 01403.077 to develop evidence of wages for migrant farm workers.

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RS 01403.059 - Statement of Claimant and Persons Who Know About Employment and Wages - 07/26/2002
Batch run: 01/27/2009