TN 16 (06-04)

The individual files IRS Form 4029 (Application for Exemption From Social Security Taxes and Waiver of Benefits) with SSA. This form is available at http://www.irs.gov/

NOTE: A survivor may file for a deceased individual.

SSA certifies that the religious sect to which the person belongs meets the requirements of the law; i.e., Section 1402(g) of the Internal Revenue Code.

IRS approves or disapproves the request and notifies the individual and SSA.

OCO Boyers, PA retains a copy of the Form 4029 and/or letter of revocation in the Correspondence File. See RS 01802.274 for Revocation of an Approved Exemption.

NOTE: A “Q” indicator on the Numident denotes the existence of information in the Correspondence File. A complete Numident must be requested at the time of application to obtain this information. For example, when checking the Numident for the existence of a “Q” indicator “Optional field #3” must be selected. If “Optional Field #3” is not selected all of the required information in the “Correspondence File” will not be provided. Sometimes a NH alleges that he/she filed a Form 4029 but the “Q” indicator is not on the Numident. The Correspondence File should be checked for the existence of a Form 4029. Requests can be made in writing, Social Security Administration, Security Records Center, ATTN: Religious Exemption Unit, Box 7, Boyers, PA 16020 or by telephone 1–888–881–5827 (dial or say “four” when prompted) and/or fax 724-794-6597. Also any changes to the Numident must be done via SSNAP or the SS5 process and requires supporting documents.

If there is an approved Form 4029 in the Correspondence File, FO’s should add a special message to the MBR to show that a claim for benefits was filed but denied due to the existence of a “ Q” indicator/ approved Form 4029 in the Correspondence File. For example, “NH is Form 4029 exempt/waiver of SSA/Medicare Benefits” or “Religious Exemption/Waiver to SSA/Medicare Benefits Applies”.