Supplemental Security Income Mobile Wage Reporting (SSIMWR)

Monthly SSI Wage Reporting

Screen ImagesOMB

Supplemental Security Income Mobile Wage Reporting (SSIMWR)

OMB: 0960-0715

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0715 can be found here:

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Screen Images and Interactions

Access Code Entry – To be removed in September 2013

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The Access Code was used to control who downloaded the app during the pilot phase. For national release, there will not be an access code. Through our pilot, we learned that users were frustrated with entering an access code. Executives made the decision to remove it completely.

These changes will occur upon OMB approval.

Terms of Service

Since the Access Code screen is going to be removed, this will be the new first screen the user sees The OMB number, Paperwork Reduction Act link, Privacy Policy link, and FAQs link from the Access Code screen are now displayed on the TOS screen.

These changes will occur upon OMB approval.

Full Terms of Service wording:

I understand that this application contains U.S. Government information.
I consent to the monitoring of my use of this application to ensure its appropriate use.
I understand that it is a federal crime to:
- Give false or misleading statements to obtain information in Social Security records; or
- Deceive the Social Security Administration of an individual’s identity.
I understand that unauthorized use of, or access to, this application may subject me to criminal or civil penalties, or both.
I understand that if I am submitting wages for someone else, I must have his or her permission to do so.
I understand that Social Security may stop me from using this service if it finds or suspects misuse.

Enter PII

1^st Appearance of Screen 2^nd / 3^rd Appearance of Screen
(Before Errors - Empty) (After Errors - prepopulated)

Changed page title from “Verify” to” Tell Us Who You Are”.

Added text “Provide information about yourself.”

Both of these changes were made to help the user understand whose information to enter.

These changes will occur upon OMB approval.

Confirm PII

Standard Name Display With Other Last Name Displayed

Changed page title from “Confirm” to “Confirm Your Information”.

This minor change was made to help the user understand they are to confirm their own inforamtion.

These changes will occur upon OMB approval.

Reporting Path Choice

Changed wording from “I am reporting wages for” to “I am reporting wages earned by.”

This change was made to help the user understand they are reporting wages earned.

These changes will occur upon OMB approval.

Wage Entry for Self

Changed page title from “Enter Wages” to “Enter Your Wages.”.

Added “gross” and definition of gross wages.

These changes were made to help the user understand that they are to enter their own gross wages.

These changes will occur upon OMB approval.

Confirm Wage Report for Self

Changed page title from “Confirm Wage Report” to “Confirm Your Wages.”.

Added the word “gross.”

These changes were made to help the user understand they were confirming their own gross wages.

These changes will occur upon OMB approval.

Enter Wages

1^st Appearance of Screen

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Changed first sentence from “Social Security number of the person you are reporting for” to Social Security number of the person who earned wages.”

Added the word “gross” and the sentence about gross wages.

Both of these changes were made to help the user understand whose information to enter and that gross wages should be reported.

These changes will occur upon OMB approval.

Before Errors - Empty)

2^nd / 3^rd Appearance of Screen
(After Errors - prepopulated)

Changed first sentence from “Social Security number of the person you are reporting for” to Social Security number of the person who earned wages.”

Added the word “gross” and the sentence about gross wages.

Both of these changes were made to help the user understand whose information to enter and that gross wages should be reported.

These changes will occur upon OMB approval.

Confirm Wage Report for Other

Changed page title from “Confirm SSN” to “Confirm SSN and Wages.”

This change was made because users were confirming both SSN and wages, so the title should reflect that.

This change will occur upon OMB approval.

Interim Successful Submission- No changes

Final Successful Submission – Within GK Dates

Changed text from “May wages may be reported from June 1 to June 9.” to “Please report May wages between June 1 and June 9.”

Added sentence with link below Log Out button.

The second sentence was changed to make the language softer. The sentence at the bottom of the screen was added to provide the user with a new reminder option to provide better customer service

This change will occur upon OMB approval.

Final Successful Submission – Outside GK Dates

Added sentence beginning with “Because we received…”

Added sentence beginning with “We will mail a notice…”

Changed text from “May wages may be reported from June 1 to June 9.” to “Please report May wages between June 1 and June 9.”

Added sentence with link below Log Out button.

These changes were made to meet the requirements of the GK enhancements to be released on 9/28/13.

The sentence at the bottom of the screen was added to provide the user with a new reminder option to provide better customer service

This change will occur upon OMB approval.

Log Out Confirmation

Added last sentence with link.

The sentence at the bottom of the screen was added to provide the user with a new reminder option to provide better customer service

This change will occur upon OMB approval.

Privacy Act Statement

Full Privacy Act Statement Wording:

Title 5 U.S.C. sections 205(a) and 1631(e), and Executive Order 9397, as amended, authorize us to collect this information. We will use the information you provide to determine eligibility for Supplemental Security Income.

Furnishing us this information is voluntary. However, failure to provide all or part of the information could prevent us from making an accurate and timely decision on Supplemental Security Income benefits.

We rarely use the information you supply for any purpose other than for making a determination relating to Supplemental Security Income benefits. However, we may use it for the administration and integrity of Social Security programs. We may also disclose information to another person or to another agency in accordance with approved routine uses, which include but are not limited to the following:

To enable a third party or an agency to assist Social Security in establishing rights to Social Security benefits and/or coverage;
To comply with Federal laws requiring the release of information from Social Security records (e.g., to the Government Accountability Office and Department of Veterans’ Affairs);

To make determinations for eligibility in similar health and income maintenance programs at the Federal, State, and local level; and,
To facilitate statistical research, audit, or investigative activities necessary to assure the integrity and improvement of Social Security programs (e.g., to the Bureau of the Census and private concerns under contract to Social Security).

We may also use the information you provide in computer matching programs. Matching programs compare our records with records kept by other Federal, State, or local government agencies. Information from these matching programs can be used to establish or verify a person’s eligibility for federally-funded or administered benefit programs and for repayment of payments or delinquent debts under these programs.

A complete list of routine uses for this information is available in Systems of Records Notice entitled, Supplemental Security Income Record, 60-0103. This notice, additional information, and information regarding our programs and systems, are available on-line at www.socialsecurity.gov or at your local Social Security office.

Paperwork Reduction Act-No changes

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Full Paperwork Reduction Act Wording:

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 control number. We estimate that it will take about 5 minutes to read the instructions, gather the facts, and answer the questions.

You may send comments on our time estimate above to: SSA, 6401 Security Blvd., Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address, not the completed report.

The OMB control number for the Supplemental Security Income Telephone Wage Reporting System and the associated instructions package is 0960-0715; expiration date 07/31/2013.

Error Message Screens

Wage Reporting Period Closed – To be removed in September 2013

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Because of the GK enhancements release scheduled on 9/28/13, users will be able to report their wages any day of the month, and will not be stuck to a certain timeframe.

This change will occur upon OMB approval.