| CMS-40B
|
Application for Enrollment in Medicare - Part B (Medical Insurance)
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| CMS-L564
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Request for Employment Information
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| HA-501-U5
|
Request for Hearing by Administrative Law Judge
|
| HA-520-U5
|
Request for Review of Hearing Decision/Order
|
| HA-539
|
Notice Regarding Substitution of Party Upon Death of Claimant
|
| 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
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| IRS W-4V
|
Voluntary Withholding Request
|
| 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
|
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
|
| SF-1199A
|
Direct Deposit Sign-Up Form
|
| SSA-1-BK
|
Application for Retirement Insurance Benefits
|
| SSA-2-BK
|
Application for Wife's or Husband's Insurance Benefits
|
| SSA-5-BK
|
Application for Mother's or Father's Insurance Benefits
|
| SSA-5-INST
|
Reporting Responsibilities for Mother's or Father's Insurance Benefits
|
| SSA-7-F6
|
Application for Parent's Insurance Benefits
|
| SSA-8
|
Application for Lump-Sum Death Payment
|
| 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-16-BK
|
Application for Disability Insurance Benefits
|
| SSA-16-BK-SP
|
Solicitud para beneficios de seguro por incapacidad
|
| SSA-16-INST
|
Reporting Responsibilities For Disability Insurance Benefits
|
| SSA-24
|
Application for Survivors Benefits (Payable Under Title II of the Social Security Act)
|
| SSA-44
|
Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event
|
| 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-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-521
|
Request for Withdrawal of Application
|
| SSA-546
|
Worker's Compensation/Public Disability Questionnaire
|
| SSA-561-U2
|
Request for Reconsideration
|
| SSA-623-F6
|
Representative Payee Report Not available online -contact your local Social Security office
|
| SSA-671
|
Railroad Employment Questionnaire
|
| SSA-781
|
Certificate of Responsibility for Welfare and Care of Child
|
| 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
|
Authorization to Disclose Information to the Social Security Administration
|
| SSA-1020-INST
|
General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs
|
| SSA-1020B-INST
|
General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs
|
| SSA-1020B-INST-SP
|
Instrucciones generales para llenar la Solicitud para el Benefi cio Adicional con los gastos del plan de medicamentos recetados de Medicare
|
| 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-1026B-OCR-SM-INST
|
Review of your Eligibility for Extra Help
|
| SSA-1026B-OCR-SM-INST-SP
|
Revisión sobre su derecho a recibir el Beneficio Adicional
|
| SSA-1560-U4
|
Petition to Obtain Approval of a Fee For Representing a Claimant Before the Social Security Administration
|
| SSA-1694
|
Request for Business Entity Taxpayer Information
|
| SSA-1695-F3
|
Identifying Information for Possible Direct Payment of Authorized Fees
|
| SSA-1696-U4
|
Appointment of Representative
|
| 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-2000-F6
|
Application for Special Benefits for World War II Veterans
|
| 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-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-3380-BK
|
Function Report - Adult - Third Party Form
|
| SSA-3381
|
Medical and Job Worksheet - Adult
|
| SSA-3441-BK
|
Disability Report - Appeal
|
| SSA-3885
|
Government Pension Questionnaire
|
| SSA-4111
|
Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits
|
| SSA-5665-BK
|
Teacher Questionnaire
|
| SSA-5666
|
Request for Administrative Information
|
| SSA-7008
|
Request for Correction of Earnings Record
|
| SSA-7050-F4
|
Request for Social Security Earnings Information
|
| SSA-7104
|
Partnership Questionnaire
|
| SSA-7163
|
Questionnaire about Employment or Self Employment
|