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Form SSA-131 (03-2020) EF Page 2 of 2
EMPLOYER INSTRUCTIONS FOR COMPLETING SPECIAL WAGE PAYMENT FORM
1. Provide the EIN that was used or will be used to report the employee's wages on the Form W-2.
2. Enter the date the employee retired. Enter "Not Retired" if the employee has not retired.
3. Enter the date that the employee last performed services; was not expected to return to work; and was not subject to recall to
render additional services. This date should be the same as or earlier than the date in item "2." Enter "Not Retired" if the
employee has not retired.
4. Enter the wages that were paid to the employee in the tax year that were for services that were performed in years prior to the
tax year or that were paid on account of retirement.
Examples (not all inclusive) of payments to be included:
• Payments in lieu of vacation that were earned in a year prior to the tax year.
• Accumulated sick payments which were paid in a lump sum based on "retirement" as the sole condition of payment.
• Accumulated sick payments paid at or after the date in item 3, which were earned in a year prior to the tax year.
• Payments "on account of retirement"--dismissal, severance or termination pay paid because of retirement.
• Bonuses which are paid pursuant to a prior contract, agreement or promise causing the employee to expect such payments
regularly; or announced to induce the employee to work more steadily, rapidly or efficiently or to remain with the employer.
• Stock Options.
Do not include in item "4" payments:
• For annual, sick, holiday or vacation pay if used (absence from work) prior to the date of retirement (earlier of items "2" or "3").
• That were reported or will be reported under "Nonqualified Plans" on the Form W-2.
• That were deducted from the employee's wages and paid to a deferred compensation plan (e.g., 401k).
• Employees health and dental plan benefits (non-covered/non-taxable for Social Security Wages).
• Bonuses earned and paid in the tax year.
5. Check whether payments listed in item 4 will be made for years after the tax year. If yes, please show the amounts and years
in which these will be paid, if known.
6. Nonqualified deferred compensation and section 457 plans only. If you were unable to report nonqualifieddeferred
compensation or section 457 plan payments and deferrals (contributions) on Form W-2 because both payments and deferrals
occurred during the year, show the amount of wages earned by the employee during the tax year. Generally, the wages
earned will be the compensation reported in block 1 of Form W-2 less payments from a nonqualified deferred compensation (or
457) plan, but including any amounts deferredunder the plan during the tax year (See IRS Publication 957).
PRIVACY ACT STATEMENT
Collection and Use of Personal Information
Sections 203(f)(5) & (6); 205(a); 205(c)(2) and 233 of the Social Security Act, as amended, allow us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent us from making
an accurate determination regarding the amount of Social Security benefits payable to the individual for the year in question.
We will use the information you provide to make a determination concerning the amount of Social Security benefits payable to the
individual. We may also share this information for the following purposes, called routine uses:
1. To any source that has, or is expected to have, information that the Social Security Administration needs in order to establish
or verify a person's eligibility for a certificate of coverage under a Social Security agreement authorized by section 233 of the
Social Security Act; and 2. To contractors and other Federal agencies, as necessary, for the purpose of assisting the Social
Security Administration in the efficient administration of our programs.
In addition, we may share this information in accordance with the Privacy Act and other Federal laws. For example, where
authorized, we may use and disclose this information in computer matching programs, in which our records are compared to
other records to establish or verify a person's eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notice, 60-0059, entitled Earnings Recordings
and Self-Employment Income System. Additional information and a full listing of all our SORNs are available on our website at
www.socialsecurity.gov/foia/bluebook.
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of
the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and
Budget (OMB) control number. We estimate that it will take about 20 minutes to read the instructions, gather the facts, and answer the
questions. Send only comments relating to our time estimate above to: SSA,6401 Security Blvd, Baltimore, MD 21235-6401.
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