Form Ssa-1945 - Statement Concerning Your Employment In A Job (Page 2 of 2) in pdf

Form Ssa-1945 - Statement Concerning Your Employment In A Job Page 2

Information about Social Security Form SSA-1945,

Statement Concerning Your Employment in a Job Not Covered by Social Security

New legislation [Section 419(c) of Public Law 108-203, the Social Security Protection

Act of 2004] requires State and local government employers to provide a statement to

employees hired January 1, 2005 or later in a job not covered under Social Security. The

statement explains how a pension from that job could affect future Social Security benefits to

which they may become entitled.

Form SSA-1945, Statement Concerning Your Employment in a Job Not Covered by Social

Security, is the document that employers should use to meet the requirements of the law. The

SSA-1945 explains the potential effects of two provisions in the Social Security law for workers

who also receive a pension based on their work in a job not covered by Social Security. The

Windfall Elimination Provision can affect the amount of a worker’s Social Security retirement or

disability benefit. The Government Pension Offset Provision can affect any possible Social

Security benefit entitlement as a spouse or an ex-spouse.

Employers must:

• Give the statement to the employee prior to the start of employment;

• Get the employee’s signature on the form; and

• Submit a copy of the signed form to the pension paying agency.

Social Security will not be setting any additional guidelines for the use of this form.

Copies of the SSA-1945 are available online at the Social Security website,

Paper copies can be requested by email at

oplm.oswm.rqct.orders@ssa.gov or by fax at 410-965-2037. The request must include the

name, complete address and telephone number of the employer. Forms will not be sent to a post

office box. Also, if appropriate, include the name of the person to whom the forms are to be

delivered. The forms are available in packages of 25. Please refer to Inventory Control Number

(ICN) 276950 when ordering.

Form Ssa-1945 - Statement Concerning Your Employment In A Job Page 2