Within four to six weeks after you return this form, SSA will send you a record of your earning history, an estimate of how much you have paid in Social Security taxes, and estimates of benefits.
Benefit estimates: estimates of benefits you (and your family) may be eligible for now and in the future.
Online: you can receive an immediate Social Security Statement online by using a free my Social Security account.
Earnings: for items 5 and 7, show only earnings covered by Social Security.
Spanish: check the box if you want to get your Statement in Spanish instead of English.
| Question | Answer |
|---|---|
| Form Name | Form SSA-7004 |
| Form Length | 3 pages |
| Fillable? | Yes |
| Fillable fields | 34 |
| Avg. time to fill out | 6 min |
| Edition | 07-2023 |
| Issuing agency | Social Security Administration |
| Other names | SSA-7004, SSA 7004, Form SSA-7004, Request for Social Security Statement, Social Security earnings statement |
| Official source | Form SSA-7004 (Rev 07-2023), Social Security Administration |
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