Social Security Forms

SS-5 Application for a Social Security Card
SSA-827 Authorization to Disclose Information to the Social Security Administration
SSA-3820-BK Disability Report - Child
IRS W-4V Voluntary Withholding Request
CMS-40B Application for Enrollment in Medicare - Part B (Medical Insurance)
CMS-L564 Request for Employment Information
CMS-L564S Solicitud De Información Sobre El Empleo
HA-85 Request to Withdraw a Hearing Request
HA-86 Discontinue Prior Editions
HA-86-SP SOLICITUD PARA RETIRAR UNA PETICIÓN PARA REVISIÓN CON EL CONSEJO DE APELACIONES
HA-501-U5 Request for Hearing by Administrative Law Judge
HA-510 Waiver of Timely Written Notice of Hearing
HA-510-SP Renuncia a la notificación escrita oportuna de la audiencia
HA-520 Request for Review of Hearing Decision/Order
HA-539 Notice Regarding Substitution of Party Upon Death of Claimant
HA-539-SP Aviso Sobre La Substitución De La Parte Interesada Tras El Fallecimiento Del Reclamante
HA-4608 Waiver of Your Right to Personal Appearance Before an Administrative Law Judge
HA-4631 Claimant's Recent Medical Treatment
HA-4632 Claimant's Medications
HA-4633 Claimant's Work Background
IRS SS-4 Application for Employer Identification Number
Online Adult Disability Report
Online Appeal a Recent Medical Decision
Online Apply for Disability Benefits
Online Apply for Retirement, Spouse's or Medicare Benefits
Online Apply Online for Extra Help with Medicare Prescription Drug Plan Costs
Online Change Address or Telephone Number
Online Child Disability Report
Online Get a Replacement Medicare Card
Online Representative Payee Accounting Report
Online Request a Form SSA-1099/1042 (Benefit Statement) for tax or other purposes
Online Request a Proof of Social Security Benefits Letter
Online Request Special Notices for the Blind or Visually Impaired
Online Sign Up For or Change Direct Deposit
SS-5-FS Application for a Social Security Card (Outside of the U.S.)
SS-5-SP Solicitud para una tarjeta de Seguro Social
SSA-1-BK Application for Retirement Insurance Benefits
SSA-1-BK-SP Solicitud Para Beneficios De Seguro Por Jubliación
SSA-2-BK Application for Wife's or Husband's Insurance Benefits
SSA-2-BK-SP Solicitud Para Beneficios De Seguro Como Cónyuge
SSA-3 Marriage Certification
SSA-3-SP CERTIFICACION DE MATRIMONIO
SSA-4-BK Application for Child's Insurance Benefits
SSA-4-BK-SP Solicitud Para Beneficios De Seguro Para Niños
SSA-4-INST Reporting Responsibilities for Child's Insurance Benefits
SSA-5-BK Application for Mother's or Father's Insurance Benefits
SSA-5-BK-SP Application For Mother's Or Father's Insurance Benefits - Spanish
SSA-5-INST Reporting Responsibilities for Mother's or Father's Insurance Benefits
SSA-7-F6 Application for Parent's Insurance Benefits
SSA-7-F6-SP Application for Parent's Insurance Benefits - Spanish
SSA-8 Application for Lump-Sum Death Payment
SSA-8-SP SOLICITUD DEL PAGO GLOBAL POR DEFUNCIÓN
SSA-10 Application for Widow's or Widower's Insurance Benefits
SSA-10-INST Reporting Responsibilities for Widow's or Widower's Insurance Benefits
SSA-10-SP Solicitud Para Beneficios de Seguro como Cónyuge Sobreviviente
SSA-16 Application for Disability Insurance Benefits
SSA-16-SP Solicitud para beneficios de seguro por incapacidad
SSA-21 Supplement to Claim of Person Outside the United States
SSA-24 Application for Survivors Benefits (Payable Under Title II of the Social Security Act)
SSA-25 Certification of Election for Reduced Spouse's Benefits
SSA-44 Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event
SSA-88 Pre-Approval Form for Consent Based Social Security Number Verification (CBSV)
SSA-89 Authorization for the Social Security Administration To Release Social Security Number (SSN) Verification
SSA-89-SP Autorización para que la Administración de Seguro Social Divulgue la Verificación de un Número de Seguro Social (SSN)
SSA-131 Employer Report of Special Wage Payments
SSA-150 Modified Benefits Formula Questionnaire
SSA-199 Vocational Rehabilitation Provider Claim
SSA-263 Waiver of Supplemental Security Income Payment Continuation
SSA-308 Modified Benefits Formula Questionnaire, Foreign Pension
SSA-437-BK Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration
SSA-437-BK-SP Formulario Para Querellas De Alegaciones De Discriminación En Los Programas De La Administración Del Seguro Social
SSA-454-BK Continuing Disability Review Report
SSA-521 Request for Withdrawal of Application
SSA-521-SP Solicitud Para Revocar Una Reclamación
SSA-545-BK Plan for Achieving Self-Support
SSA-546 Worker's Compensation/Public Disability Questionnaire
SSA-561-U2 Request for Reconsideration
SSA-604 Certificate of Incapacity
SSA-632-BK Request for Waiver of Overpayment Recovery
SSA-632-BK-SP Solicitud de exoneración de sobrepago
SSA-634 Request for Change in Overpayment Recovery Rate
SSA-634-SP Solicitud de cambio en la tasa de recuperación de sobrepago
SSA-640 Financial Disclosure for Civil Monetary Penatly (CMP) Debt
SSA-671 Railroad Employment Questionnaire
SSA-711 Request for Deceased Individual's Social Security Record
SSA-714 You can make your payment by Credit Card
SSA-721 Statement of Death by Funeral Director
SSA-731 Notice to Electronic Information Exchange Partners to Provide Contractor List
SSA-753 Statement Regarding Marriage
SSA-754-F5 Statement of Marital Relationship
SSA-769-U4 Request for Change in Time/Place of Disability Hearing
SSA-770-U4 Notice Regarding Substitution of Party Upon Death of Claimant Reconsideration of Disability Cessation
SSA-773-U4 Waiver Of Right To Appear - Disability Hearing
SSA-781 Certificate of Responsibility for Welfare and Care of Child
SSA-783 Statement Regarding Contributions
SSA-788 Statement of Care and Responsibility for Beneficiary
SSA-789-U4 Request for Reconsideration - Disability Cessation
SSA-795 Statement of Claimant or Other Persons
SSA-820-BK Work Activity Report (Self-Employed Person)
SSA-821-BK Work Activity Report
SSA-827-INST Instructions for Completing the SSA-827
SSA-827-INST-SP Instrucciones para completar el formulario SSA-827
SSA-1020-INST General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1021 Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1021-SP Apelación de la determinación para recibir el Beneficio Adicional con los gastos del plan de medicamentos recetados de Medicare
SSA-1021-INST Instructions for Completing the Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1021-INST-SP Instrucciones para llenar la apelación de la determinación para recibir el beneficio adicional con los gastos del plan de medicamentos recetados de Medicare
SSA-1199 International Direct Deposit (IDD)
SSA-1372-BK Advanced Notice of Termination of Child's Benefits
SSA-1372-BK-FC Advanced Notice of Termination of Child's Benefits (Foreign Claims)
SSA-1372-BK-FC-SP Adviso Por Adelantado De Cese De Beneficios Para Niños
SSA-1383 Student Reporting Form
SSA-1383-FC Reporting to Social Security Administration by Student Outside the United States
SSA-1414 Credit Card Payment Form
SSA-1458 Certification By Religious Group
SSA-1560 Petition For Authorization To Charge And Collect A Fee For Services Before The Social Security Administration
SSA-1691 Eligible Non-Attorney Representative Application
SSA-1693 Fee Agreement for Representation Before the Social Security Administration
SSA-1694 Request for Business Entity Taxpayer Information
SSA-1696 Claimant's Appointment of Representative
SSA-1696-SUP1 Claimant's Revocation of the Appointment of a Representative
SSA-1696-SUP2 Representative's Withdrawal of Acceptance of Appointment
SSA-1699 Registration for Appointed Representative Services and Direct Payment
SSA-1724-F4 Claim for Amounts due in case of a Deceased Beneficiary
SSA-1945 Statement Concerning Your Employment in a Job Not Covered by Social Security
SSA-2010-F6 Statement for Determining Continuing Entitlement for Special Veterans Benefits (SVB)
SSA-2032-BK Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate
SSA-2512 Pre-1957 Military Service Federal Benefit Questionnaire
SSA-2519 Child Relationship Statement
SSA-2855 Statement of Funds you Received
SSA-3033 Employee Work Activity Questionnaire
SSA-3105 Important information about your appeal, waiver rights, and repayment options
SSA-3288 Consent for Release of Information
SSA-3288-SP Consentimiento para divulgar información
SSA-3368-BK Disability Report - Adult
SSA-3369-BK Work History Report
SSA-3373-BK Function Report - Adult
SSA-3375-BK Function Report - Child Birth to 1st Birthday
SSA-3376-BK Function Report - Child Age 1 to 3rd Birthday
SSA-3377-BK Function Report - Child Age 3 to 6th Birthday
SSA-3378-BK Function Report - Child Age 6 to 12th Birthday
SSA-3379-BK Function Report - Child Age 12 to 18th Birthday
SSA-3380-BK Function Report - Adult - Third Party Form
SSA-3441-BK Disability Report - Appeal
SSA-3881-BK Questionnaire for Children Claiming SSI Benefits
SSA-3885 Government Pension Questionnaire
SSA-4111 Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits
SSA-4162 Child Care Dropout Questionnaire
SSA-4814 Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
SSA-4815 Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
SSA-5062 Claimant's Statement about Loan of Food or Shelter
SSA-5665-BK Teacher Questionnaire
SSA-5665-BK-SP Cuestionario para Maestros (Teacher Questionnaire)
SSA-5666 Request for Administrative Information
SSA-7004 Request for Social Security Statement
SSA-7004-SP Solicitud para un Estado de cuenta del Seguro Social
SSA-7008 Request for Correction of Earnings Record
SSA-7050-F4 Request for Social Security Earnings Information
SSA-7104 Partnership Questionnaire
SSA-7156 Farm Self Employment Questionnaire
SSA-7157-F4 Farm Arrangement Questionnaire
SSA-7160 Employment Relationship Questionnaire
SSA-7163 Questionnaire about Employment or Self Employment
SSA-7163A-F4 Supplemental Statement Regarding Farming Activities
SSA-8240 Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers
SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information
SSA-L447 Medicare Savings Programs Eligible Letters
SSA-L447-SP Cartas para saber si tiene derecho al Programa de ahorros de Medicare