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Ssa 3033 form02 2011 ef 02 2011-2026

The document is a communication from the Social Security Administration requesting information from an employer regarding an employee's work activity to determine if it was subsidized or constituted an unsuccessful work attempt. It includes a questionnaire for the employer to complete, detailing aspects of the employee's job performance and any special assistance provided. The document emphasizes confidentiality and outlines the legal basis for collecting this information, as well as instructions for submission.

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Click ‘Get Form’ to open the SSA 3033 form in the editor.
Begin by entering the date and claim number at the top of the form. This information is crucial for tracking your submission.
Fill in the employee's Social Security Number and worker's name in the designated fields to ensure proper identification.
In Section 1, answer questions regarding the employee's usual duties, ability to complete job tasks without assistance, and attendance. Use checkboxes for clarity.
Provide details about any special assistance received by the employee, selecting all applicable options from the list provided.
Rate the employee's productivity compared to peers using the percentage options available. This helps assess their performance accurately.
Complete Section 2 by answering questions related to unsuccessful work attempts, ensuring you provide honest assessments.
Finally, sign and date the form in Section 3, including your title and contact number for follow-up if necessary.

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