Saturday, August 24, 2019

Sample legal forms and business documents

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Benefit Application Supporting Forms

Form TitleCoverage
SSA-11 Request to Be Selected As Payee All States
SSA-1372 Advanced Notice of Termination of Child's Benefits All States
SSA-1372-BK-FC Advance Notice of Termination of Child’s Benefits (Foreign Claims) All States
SSA-150 Modified Benefits Formula Questionnaire All States
SSA-2032 Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate All States
SSA-21 Supplement to Claim of Person Outside the United States All States
SSA-25 Certification of Election for Reduced Spouse's Benefits All States
SSA-2512 Pre-1957 Military Service Federal Benefit Questionnaire All States
SSA-2519 Child Relationship Statement All States
SSA-3-SP Certificación de Matrimonio All States
SSA-308 Modified Benefits Formula Questionnaire, Foreign Pension All States
SSA-3885 Government Pension Questionnaire All States
SSA-4111 Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits All States
SSA-4184 Self Employment Corporate Officer Questionnaire All States
SSA-437 Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration All States
SSA-521 Request for Withdrawal of Application All States
SSA-5666 Request for Administrative Information All States
SSA-671 Railroad Employment Questionnaire All States
SSA-7008 Request for Correction of Earnings Record All States
SSA-7104 Partnership Questionnaire All States
SSA-7156 Farm Self Employment Questionnaire All States
SSA-7157 Farm Arrangement Questionnaire All States
SSA-7163 Questionnaire About Employment or Self Employment All States
SSA-7163A Supplemental Statement Regarding Farming Activities All States
SSA-723 Statement Regarding the Inferred Death of an Individual All States
SSA-781 Certificate of Responsibility for Welfare and Care of Child All States
SSA-783 Statement Regarding Contributions All States
SSA-787 Physician's/Medical Officer's Statement of Patient's Capability to Manage Benefits All States
SSA-795 Statement of Claimant or Other Persons All States