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Request for Self-Employment
Request for Self-Employment - SSA needs the information collected on Forms SSA-L2765, SSA-L3365, and SSA-L4002 in order to credit the reported earnings to the proper earnings record. When W-2 wage data for an individual cannot be identified, the data are placed in the earnings suspense file, and SSA sends decentralized correspondence (D?COR) to the employee (and in certain instances to the employer) in an attempt to obtain his/her correct name and SSN. If the respondent furnishes the name and SSN information which agrees with SSA's records, or provides information which resolves the discrepancy, the reported earnings are added to his or her Social Security record.
Form #:  SSA L4002 C1
Agency:  Social Security Administration
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
NEEDED
paper Both Form and Instructions 2   [1] Paper Only Other Client Software  

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