Application
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All forms are FREE. Not all forms are listed. If you can't find the form you need, or you need help completing a form, please call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office and we will help you. If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you.
Application For Social Security Card
Application definition, the act of putting to a special use or purpose: the application of common sense to a problem.
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Nbi Clearance Online Application
Job Applications Online
| Number | Title |
|---|---|
| SS-5 | Application for a Social Security Card In some areas, you may request a replacement Social Security card online. |
| 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-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-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-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-16 | Application for Disability Insurance Benefits |
| SSA-16-SP | Solicitud para beneficios de seguro por incapacidad |
| SSA-16-INST | Reporting Responsibilities For Disability Insurance Benefits |
| 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-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-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-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-3194 | Permanent Medical Parking Renewal Certification |
| 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-5666 | Request for Administrative Information |
| SSA-7004 | Request for Social Security Statement |
| 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 |