When an employee's work is subsidized, the Social Security Administration does not consider any earnings above the reasonable value of the work or services performed.
Who completes it: this could be a supervisor or the employee's employment service provider, such as a job coach, job developer, or other knowledgeable source.
Return: the Social Security Administration would appreciate it if you would complete and return the questionnaire to this office within 15 days, or as soon as possible.
Worker no longer employed: please complete the questionnaire even if the worker is no longer employed.
Subsidy percentage: approximately what percentage of this employee's pay exceeds the reasonable value of the work or services they perform?
| Question | Answer |
|---|---|
| Form Name | Form SSA-3033 |
| Form Length | 5 pages |
| Fillable? | Yes |
| Fillable fields | 57 |
| Avg. time to fill out | 10 min |
| Other names | SSA-3033, SSA3033, SSA 3033, Form SSA-3033, Work Activity Questionnaire |
| Edition | 01-2026 |
| Issuing agency | Social Security Administration |
| Estimate | about 15 minutes to read the instructions, gather the facts, and answer the questions |
| Official source | Form SSA-3033 (Rev 01-2026), Social Security Administration |
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