Form SSA-1945 PDF Details

Page 1 is the statement and page 2 holds the information about Form SSA-1945.

Signature: employers must get the employee's signature on the form.

Employee copy: give the signed statement and information page to the employee prior to the start of employment.

Copy: submit a copy of the signed form to the pension paying agency.

Credits: you will not earn credits for Social Security retirement or disability benefits in this job.

Medicare: earnings from this job are subject to Medicare taxes and will count for purposes of the Medicare program.

QuestionAnswer
Form NameForm SSA-1945
Form Length2 pages
Fillable?Yes
Fillable fields14
Avg. time to fill out3 min
Edition03-2025
Issuing agencySocial Security Administration
Where to sendThe employer gives the signed statement and information page to the employee prior to the start of employment and submits a copy of the signed form to the pension paying agency
Other namesSSA-1945, SSA1945, SSA 1945, SSA-45, SSA 45, Statement Concerning Your Employment in a Job Not Covered by Social Security
Official sourceForm SSA-1945 (Rev 03-2025), Social Security Administration

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