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Verify-name-ssn Verifying Social Security Numbers for All Employees

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W
Payroll Office • Wooster, OH 44691 • TEL. 330/263-2085 or 330/263-2295 • FAX 330/263-2281
Verifying Names and Social Security Numbers for All Employees
We require all new hires to provide us with their legal name (as stated on their social
security card) and social security number so we can verify this information via the Social
Security Number Verification Service (SSNVS). This will ensure that all employees’
names and social security numbers match the Social Security Administration’s (SSA)
records. By adopting this process, it will reduce the number of corrected W-2s, assist in
complying with IRS regulations, and enable the SSA to properly credit employee
earnings records.
Thank you for your assistance.
Legal Name (as stated on social security card): _________________________________
(print legibly)
Social Security Number: ________________________
Date of Birth (MM/DD/YY): _____________________
Signature: ________________________________
For office use only:
Submitted to SSNVS: ___________
Accepted from SSNVS: ____________
Rejected from SSNVS: ____________
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Verify-name-ssn Verifying Social Security Numbers for All Employees

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Completed 18 November 2019

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