Form Ssa-131 - Employer Report Of Special Wage Payments
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1
2Form Approved
Social Security Administration
OMB No. 0960-0565
EMPLOYER REPORT OF SPECIAL WAGE PAYMENTS
PART I - TO BE COMPLETED BY SSA/EMPLOYER:
Tax Year Employee Name
Employee's SSN
SSA Claim Number
(To be completed by SSA)
Employer
Address
PART 2 - TO BE COMPLETED BY EMPLOYER:
Employees are sometime paid wages in a year subsequent to the year that the wages were earned. The most common
types of payments are accumulated (for prior years) vacation pay or sick pay paid after retirement; deferred
compensation; severance pay (when paid on account of retirement) and bonuses--paid pursuant to a prior agreement or
contract.
Wages which are earned in a year prior to the year they are paid usually do not affect benefits payable under the Social
Security annual earnings test. However, for the Social Security Administration to pay benefits accurately, these prior
year amounts must be reported to us. The above named individual has filed for Social Security benefits. To ensure that
correct Social Security benefits are paid, please complete the information below and return this form to the Social
Security Administration. (Please see reverse side for instructions for the completion of this form.)
1. Employer Identification Number
2. Retirement date
3. Date employee last performed services
(EIN)
(MM/DD/YYYY)
(MM/DD/YYYY)
If the dates in items 2 and 3 are not the same, please explain the difference.
4. For wages paid to the employee in the "tax year" (see Part I above), enter the amount that was for
services performed prior to the tax year; or was not attributable to services rendered during the tax
$
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year; or was paid on account of retirement:
Check the type(s) of wages paid in the tax year but for services performed in a prior year or were paid on account of retirement.
Vacation Pay
Sick Pay
Severance Pay
Bonus
Deferred Compensation
Other (Explain)
5. Will payments listed in item "4" be made for years after the tax year?
Yes
No
If answered Yes, please show the amounts and years in which these amounts will be paid, if known.
Amount
Year
Amount
Year
6. Nonqualified deferred compensation and section 457 plans only. If payments and deferrals
occurred during the tax year, enter the amount of wages earned by the employee during
$
the tax year.
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Signature
Title
Date
Phone Number
Form SSA-131 (8-2001) EF (06-2002)
(Over)
Destroy Prior Editions
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