Form SSA-4162. Child Care Dropout Questionnaire

Form SSA-4162, the Child Care Dropout Questionnaire, is used to collect information about periods when a parent or guardian had to reduce or stop work due to the need for childcare. The primary purpose of this form is to allow individuals to report interruptions in their work history caused by childcare responsibilities.

For example, a parent who had to reduce work hours or temporarily leave their job to care for a child may use this form to explain the childcare-related gaps in their employment history. The purpose is to ensure that these individuals are not penalized for periods of reduced work due to childcare responsibilities when calculating Social Security benefits.

The parties involved are parents or guardians who have experienced interruptions in their work history due to childcare and the SSA. The form typically consists of sections where the individual describes the periods of reduced or interrupted work and the reason for it. Accurate reporting is important to ensure that work history is accurately considered in benefit calculations.