This is an example of Form 8161 (Rev 10-88) with the following filled out:1. SS. or EI number 0000074052. Form number 10403. PERIOD 20XX124. DATE 20XX-04-265. DLN AND PROCESSING YEAR 00212-059-11753-X6. NAME CONTROL QQ7. CONTROL DAY 1098. ERS Suspense 900 Unpostable Record 9. Employee Number 290 6 630