The SSA-7004 form, formally the Request for Social Security Statement, is a one-page paper form you complete and mail to the Social Security Administration to receive a printed statement of your earnings history and estimated retirement, disability, and survivors benefits. Fill in your identifying information, last year’s and this year’s earnings, your planned retirement age, and a future average yearly earnings figure; sign and date it; then mail it to the Wilkes-Barre Direct Operations Center in Pennsylvania. Your statement arrives by mail within four to six weeks.1Social Security Administration. Request for a Social Security Statement (SSA-7004)
Getting a Blank Copy of the Form
There are three ways to obtain the form. You can download and print it as a PDF from ssa.gov.1Social Security Administration. Request for a Social Security Statement (SSA-7004) You can call SSA’s toll-free line at 1-800-772-1213 (TTY 1-800-325-0778) and ask for a copy to be mailed to you at no charge.2Social Security Administration. Request for Social Security Statement Or you can pick up a blank form in person at a local Social Security office.
Before you start writing, pull out your most recent W-2 or tax return. Two of the fields ask for dollar amounts you probably don’t have memorized, and guessing will throw off the estimates SSA sends back.
How to Complete the Sixteen Fields
The form is short but precise. Enter information exactly, and don’t leave the signature line blank — an unsigned form will be rejected.
- Fields 1–3, Name, Social Security Number, and Date of Birth. Write your full legal name exactly as it appears on your Social Security card, your nine-digit SSN, and your birth date. A name that doesn’t match the card is the most common cause of processing delays.
- Field 4, Other Social Security Numbers. List any other SSNs you have used, including a prior number issued before a name change or one used in error. This lets SSA pull all your earnings onto a single record.
- Fields 5A and 5B, Last Year’s and This Year’s Earnings. Enter your actual earnings for last year and your estimate for the current year, in whole dollars. Use your W-2 or final pay stub for last year and your best projection for this year. If you are self-employed, use net self-employment income.
- Field 6, Planned Retirement Age. Enter the age at which you realistically expect to stop working. SSA uses this to decide how many additional earning years to factor into your benefit projection.
- Field 7, Future Average Yearly Earnings. Enter the average annual amount you expect to earn between now and the retirement age in Field 6. This is a single-year average, not a lifetime total.
- Field 8, Where to Send the Statement. Indicate whether the statement should go to you or to someone else, such as an accountant or a pension plan administrator.
- Fields 9–12, Mailing Address. Provide the complete mailing address for whoever you named in Field 8. Include apartment numbers, P.O. boxes, or foreign address details as needed.
- Field 13, Spanish Statement. Check the box if you want the statement printed in Spanish.
- Fields 14–16, Signature, Phone, and Date. Sign in ink (a printed name is not a signature), add a daytime phone number, and date the form.
Federal regulations require SSA to send an earnings statement and benefit estimate to any worker who submits a valid written request, and the SSA-7004 is the prescribed form.3Social Security Administration. 20 CFR 404.810 – How to Obtain a Statement of Earnings and a Benefit Estimate Statement A written request that isn’t on the official form is also acceptable, provided it is signed, dated, and includes all the information the form asks for.
Where to Mail the Completed Form
Mail the signed form to:2Social Security Administration. Request for Social Security Statement
Social Security Administration
Wilkes-Barre Direct Operations Center
P.O. Box 7004
Wilkes-Barre, PA 18767-7004
Expect the printed statement to arrive within four to six weeks.1Social Security Administration. Request for a Social Security Statement (SSA-7004) That window covers SSA’s processing time plus postal delivery. Federal holidays and heavy filing seasons can stretch it a little longer.
What Your Statement Will Contain
The statement you receive back is a personalized snapshot in three parts: your earnings history, your estimated benefits, and your work credits.
The earnings history lists your reported wages or self-employment income for every year you have worked. This is the record SSA uses to calculate your benefits, so scan it for missing years or wrong totals. Even one missing year of high earnings can lower your eventual monthly payment.
The benefit estimates section shows projected monthly amounts at multiple retirement ages, along with figures for disability benefits if you become unable to work and survivors benefits your family could receive if you die.4Social Security Administration. How Can I Get a Social Security Statement? The redesigned statement now displays retirement estimates at nine different ages rather than the older three-age format.5Social Security Administration. Get Your Social Security Statement
The credits section shows how many Social Security work credits you have accumulated. You need 40 credits to qualify for retirement benefits.6Social Security Administration. Social Security Credits and Benefit Eligibility In 2026, one credit is earned for every $1,890 in wages or self-employment income, up to four credits per year, so anyone earning at least $7,560 in 2026 maxes out that year’s credits.7Social Security Administration. Quarter of Coverage
If You’d Rather Not Wait for the Mail
The same information the paper statement provides is available instantly through a free “my Social Security” account at ssa.gov, which pulls your actual earnings record and lets you adjust future income assumptions to see how they change your projected benefits.8Social Security Administration. Get a Benefits Estimate To create an account, you verify your identity through Login.gov or ID.me, either of which requires multi-factor authentication such as a phone number or authentication app.9Social Security Administration. Verify Your Identity If you already use Login.gov or ID.me for another government service, that same login works here.
SSA also mails paper statements automatically, without a request, to workers age 60 and older who do not have an online account and are not yet receiving benefits. Those statements go out roughly three months before each birthday.10Social Security Administration. The Social Security Statement Workers with an online account get an email reminder instead of a mailed statement. The SSA-7004 fills the gap for everyone else who wants a paper statement on demand, or who wants one sent directly to a financial planner or pension administrator.