The form explains how public employment may affect social security benefits. Request for waiver of special veterans benefits (svb) overpayment recovery or change in repayment rate: When you retire, or if you become disabled, you may receive a pension based on earnings from this job. Statement concerning your employment in a job not covered by social security: Your earnings from this job are not covered under social security.

Information about statement concerning your employment in a job not covered by social security. Statement concerning your employment in a job not covered by social security. Your earnings from this job are not covered under social security. Statement concerning your employment in a job not covered by social security:

When you retire, or if you become disabled, you may receive a pension based on earnings from this job. Information about statement concerning your employment in a job not covered by social security. Please be advised that your earnings from this position are not covered under social security.

Your earnings from this job are not covered under social security. When you retire, or if you become disabled, you may receive a pension based on earnings from this job. Please be advised that your earnings from this position are not covered under social security. When you retire, or if you become disabled, you may receive a pension based on earnings from this position. Request for waiver of special veterans benefits (svb) overpayment recovery or change in repayment rate:

Information about statement concerning your employment in a job not covered by social security. The form explains how public employment may affect social security benefits. Request for waiver of special veterans benefits (svb) overpayment recovery or change in repayment rate:

If You Are An Employer And Need Paper Copies Of The Document, You Can Request Them From The Ssa By Email Or Fax.

Web the form was issued by the u.s. You must submit a copy to sers once it has been signed by the employee. Please be advised that your earnings from this position are not covered under social security. When you retire, or if you become disabled, you may receive a pension based on earnings from this position.

A Copy Of The Signed Form Is To Be Sent To Trs By The Employer.

Social security administration (ssa) on january 1, 2013 , with all previous editions obsolete. Statement concerning your employment in a job not covered by social security: Request for waiver of special veterans benefits (svb) overpayment recovery or change in repayment rate: Your earnings from this job are not covered under social security.

The Form Explains How Public Employment May Affect Social Security Benefits.

Web the social security protection act of 2004 requires state government employers to provide a statement to employees hired january 1, 2005 or later in a job not covered under social security. When you retire, or if you become disabled, you may receive a pension based on earnings from this job. Please be advised that your earnings from this position are not covered under social security. Information about statement concerning your employment in a job not covered by social security.

Statement Concerning Your Employment In A Job Not Covered By Social Security.

Your earnings from this job are not covered under social security. When you retire, or if you become disabled, you may receive a pension based on earnings from this job. When you retire, or if you become disabled, you may receive a pension based on earnings from this position. If you are an employer and need paper copies of the document, you can request them from the ssa by email or fax. A copy of the signed form is to be sent to trs by the employer.