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Letter to Report Earnings to Social Security

During the Trial Work Period, it is important to keep Social Security informed of your earnings and a record of how many Trial Work months remain. Keep a photocopy of the letter you send, and file it in case you need it in the future. The following is a sample letter that you could use.

Social Security Administration
[Street address]
[City, State, Zip Code]

Re: Earnings during the Trial Work Period

Dear [Your Social Security Representative]:

I am writing to report to you that during the month of _______________, 201_. I was employed by [company name], which is located at [street address, city, state, zip code]. My gross monthly earnings were $_____. I have attached copies of these earnings.

Based on this earnings level, this month [counts/does not count (choose one)] as a Trial Work Period month. According to my records, I have _____ Trial Work Period months remaining.

Please notify me if you disagree with any of this information.


[Your Name]
[Your Address]
[Your Telephone Number]

[Your Claim Number]

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