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USSSARev. 01-2023

Official form guide

Form SSA-7004: Request for Social Security Statement

Requests a statement of your Social Security earnings history and estimated future benefits from SSA.

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Form Overview

SSA Form SSA-7004 - Request for Social Security Statement

Requests a statement of your Social Security earnings history and estimated future benefits from SSA.

A personalized Social Security Statement showing your earnings history and estimated benefit amounts.

Risk Radar

Scan points
  • 1Not reviewing your statement annually — errors in your earnings record must be corrected while records are available.
  • 2Using wrong SSN — the statement will reflect another person's record.

Plain English

Use this form to get a copy of your Social Security statement showing your earnings record and estimated retirement, disability, and survivor benefits.

Submission Date

  • Filing date: Request any time, but especially useful before making retirement or financial planning decisions.
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

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Glossary Terms

future

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Field map

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6 fields

Personal Info

4 items

Name

Your full name.

Requiredtext
Social Security Number

Your SSN.

Requiredssn
Date of Birth

Your date of birth.

Requireddate
Current Address

Where SSA should mail your statement.

Requiredtext

Work History

1 items

Age at Which You Plan to Stop Working

Estimated retirement age for benefit calculation purposes.

text

Signature

1 items

Signature

Your signature authorizing SSA to send your statement.

Requiredsignature

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Quick Facts

Any U.S. worker who wants to review their Social Security earnings record or get an estimate of future benefits.
A personalized Social Security Statement showing your earnings history and estimated benefit amounts.
Request any time, but especially useful before making retirement or financial planning decisions.
Mail the completed form to SSA or create a my Social Security account at ssa.gov for instant online access.
Reviewing your earnings record helps catch errors that could reduce your future benefits.
Complete the form with your personal information and mail it to SSA, or access your statement online at ssa.gov/myaccount.

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Copyright & Licensing - US Government Forms

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Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
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