Missing and Discrepant Wage Reports Letter and Questionnaire

OMB: 0960-0432

IC ID: 9293

Documents and Forms

Document Name Document Type
Form SSA-95-SM Missing and Discrepant Wage Reports Letter and Questionnaire Form
SSA-L94-SM (current).pdf Other-Cover Letter
SSA-L94-SM (current).pdf Other-Cover Letter
SSA-L93-SM (current).pdf Other-Cover Letter
SSA-L93-SM (current).pdf Other-Cover Letter
Pamphlet.docx Other-Pamhet
Pamphlet.docx Other-Pamhet
SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Re SSA-95-SM (revised).pdf Form
SSA-95-SM Employer Questionnaire--SSA Has No Record of Employer Re SSA-95-SM (revised).pdf Form
SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA SSA-97-SM (current).pdf Form
SSA-97-SM Employer Questionnaire--Discrepancy Between IRS and SSA SSA-97-SM (current).pdf Form
SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Recor SSA-95-SM2 (revised).pdf Form
SSA-95-SM (second Second Request- Employer Questionnaire--SSA Has No Recor SSA-95-SM2 (revised).pdf Form
SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Betw SSA-97-SM2 (current).pdf Form
SSA-97-SM (second Second Request -Employer Questionnaire- Discrepancy Betw SSA-97-SM2 (current).pdf Form
SSA-95-SM (current).pdf SSA-95-SM (No Record Questionnaire first request) (current) IC Document
SSA-95-SM (current).pdf SSA-95-SM (No Record Questionnaire first request) (current) IC Document
SSA-95-SM2 (current).pdf SSA-95-SM2 (No Record Questionnaire second request) (current) IC Document
SSA-95-SM2 (current).pdf SSA-95-SM2 (No Record Questionnaire second request) (current) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Missing and Discrepant Wage Reports Letter and Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 31.6051-2

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	SSA-95-SM	Employer Questionnaire--SSA Has No Record of Employer Report	SSA-95-SM (revised).pdf	No	Paper Only
Form	SSA-97-SM	Employer Questionnaire--Discrepancy Between IRS and SSA Records	SSA-97-SM (current).pdf	No	Paper Only
Other-Cover Letter			SSA-L94-SM (current).pdf	No	Paper Only
Other-Cover Letter			SSA-L93-SM (current).pdf	No	Paper Only
Form	SSA-95-SM (second request)	Second Request- Employer Questionnaire--SSA Has No Record of Employer Report	SSA-95-SM2 (revised).pdf	No	Paper Only
Form	SSA-97-SM (second request)	Second Request -Employer Questionnaire- Discrepancy Between IRS and SSA Records	SSA-97-SM2 (current).pdf	No	Paper Only
Other-Pamhet			Pamphlet.docx	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 356,800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	356,800	356,800
Annual IC Time Burden (Hours)	356,800	356,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-95-SM (No Record Questionnaire first request) (current)	SSA-95-SM (current).pdf	09/02/2025
SSA-95-SM2 (No Record Questionnaire second request) (current)	SSA-95-SM2 (current).pdf	09/02/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.