An authorized SSA employee may certify to the contents of the employer's records where the employer, representative of the employer, or the custodian of the records will not, or cannot, execute a statement but makes the records available to the authorized SSA employee.

Prepare a certification based on the employer's records on either a Form SSA-5002 (Report of Contact) or the RPOC screen for MCS claims (MSOM MCS 008.007).

The certification will show:

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  that the employer's records were examined;

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  that the certification was prepared from those records;

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  pertinent wage information contained in the employer's records (e.g., periods of employment, amounts, etc.);

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  the business name (and trade name, if any) and address of the employer;

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  the employer's Employer Identification Number (EIN);

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  the type of records examined; and

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  the reason for not obtaining the employer's or custodian's signed statement.