Form SS-5. Application for a Social Security Card

The Application for a Social Security Card, represented by Form SS-5, serves the primary purpose of facilitating individuals' interactions with the Social Security Administration (SSA) in the United States. It is a versatile form that individuals can use to:

• Apply for an original Social Security card: Individuals who have never had a Social Security number can use this form to request a new card.
• Apply for a replacement Social Security card: People who have lost their card or need a replacement can apply for a new one using this form.
• Change or correct information on their Social Security number record: Individuals can use the form to update or correct their personal information, such as name, citizenship status, or date of birth.

Usage Case: Individuals use Form SS-5 in various situations:

1. Initial Application for a Social Security Card: Typically, this form is used by individuals who have reached the age of eligibility or have a valid reason to obtain a Social Security number for the first time. Examples include U.S. citizens who need a Social Security number for employment, tax purposes, or government benefits.

2. Replacement of a Lost or Damaged Card: In case a Social Security card is lost, stolen, or damaged, the affected individuals can request a new card using this form.

3. Name Change or Correction: If individuals need to change their name on their Social Security card due to marriage, divorce, or any other reason, this form allows them to request a corrected card.

4. Correction of Date of Birth or Citizenship Status: Individuals who identify errors in their date of birth or citizenship status can use the form to request corrections in their Social Security records.

Form Structure:

The Application for a Social Security Card (Form SS-5) consists of several sections and fields:

Section 1: Personal Information

• Full name as it should appear on the Social Security card.
• Full name at birth, if different.
• Any other names used.
• Previously assigned Social Security number (if applicable).
• Place of birth, including city, state, or foreign country.

Section 2: Age, Citizenship, Ethnicity, and Race Information

• Date of birth (MM/DD/YYYY).
• Citizenship status.
• Ethnicity (voluntary).
• Race (voluntary).

Section 3: Gender Information

• Gender (Male, Female, Unknown).

Section 4: Parental Information

• Mother's name and Social Security number (if applicable).
• Father's name and Social Security number (if applicable).

Section 5: Prior Social Security Card Information

• Information regarding any previous applications for a Social Security number card, including the name on the previous card and any different date of birth.

Section 6: Current Date and Contact Information

• Today's date.
• Daytime phone number.
• Mailing address, including street address, city, state, foreign country, and ZIP code.

Section 7: Declaration

• A declaration that all provided information is true and correct.

Section 8: Signature

• A space for the applicant's signature.

Section 9: Relationship to the Person in Item 1

• An indication of the applicant's relationship to the person in item 1 (e.g., self, parent, legal guardian).

Section 10: SSA Use Only

• Space for SSA personnel to review evidence and conduct interviews.
• Date of document collection and review.

Section 11: Privacy Act Statement

• Information regarding the collection and use of personal data in accordance with the Privacy Act.

Section 12: Paperwork Reduction Act Statement

• Information about the estimated time required to complete the form and where to send comments regarding the burden estimate.

Additional Information:

• The form also provides guidance on the types of evidence documents needed to support the application. It specifies acceptable documents for proving age, identity, U.S. citizenship, or immigration status.
• Form SS-5 must be completed using black or blue ink, and it should be legible.
• The form includes contact information for the SSA, guidance on how to submit the application, and reminders for safeguarding Social Security numbers and cards to prevent identity theft.
• Certain sections, such as race and ethnicity information, are voluntary and do not impact the processing of the application.
• The form contains privacy and paperwork reduction act statements for transparency.