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Appendix This appendix explains items shown on Form SSA-1099 and Form RRB-1099. Forms SSA-1042S and RRB-1042S, for nonresident aliens, contain the same items plus a few additional ones. These are also ex- plained. The illustrated versions of Form SSA-1099, SSA-1042S, RRB-1099, and RRB-1042S in this appendix are proof copies of the forms as they appeared when this publication went to print. The informa- tion on the illustrated forms should essentially be the same as the information on the form you received from ei- ther the SSA or the RRB. You should, however, compare the form you received with the one shown in this publica- tion to note any differences. Form SSA-1099, Social Security Benefit Statement 2022 Every person who received social security benefits will re- ceive a Form SSA-1099. If you receive benefits on more than one social security record, you may get more than one Form SSA-1099. IRS Notice 703 will be enclosed with CAUTION ! this form. It contains a worksheet to help you figure if any of your benefits are taxable. Don’t mail Notice 703 to ei- ther the IRS or the SSA. Box 1—Name The name shown in this box refers to the person for whom the social security benefits shown on the statement were paid. If you received benefits for yourself, your name will be shown. Box 2—Beneficiary's Social Security Number This is the U.S. social security number, if known, of the person named in box 1. In all your correspondence with the SSA, be sure to use the claim number shown in box 8. Box 3—Benefits Paid in 2022 The figure shown in this box is the total benefits paid in 2022 to you (the person named in box 1). This figure may not agree with the amounts you actually received because adjustments may have been made to your benefits before TIP SAMPLE FORM SSA-1099 – SOCIAL SECURITY BENEFIT STATEMENT • PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME. • SEE THE REVERSE FOR MORE INFORMATION. Box 1. Name Box 2. Beneficiary’s Social Security Number Box 6. Voluntary Federal Income Tax Withheld Box 8. Claim Number (Use this number if you need to contact SSA.) DESCRIPTION OF AMOUNT IN BOX D 3 ESCRIPTION OF AMOUNT IN BOX 4 Form SSA-1099-SM (1-2023) Box 3. Benefits Paid in 2022 Box 5. Net Benefits for 2022 (Box 3 minus Box 4) Box 7. Address DO NOT RETURN THIS FORM TO SSA OR IRS Box 4. Benefits Repaid to SSA in 2022 2022 Page 20 Publication 915 (2022)