Form SSA-3369-BK. Work History Report

Form SSA-3369-BK, the Work History Report, is used to collect detailed information about an individual's work history. The main purpose of this form is to document an individual's past employment and earnings, which is crucial for the SSA to assess eligibility for disability benefits, retirement benefits, and other programs.

For example, when someone applies for Social Security disability benefits, they may need to complete this form to provide a comprehensive account of their work history. The purpose is to help the SSA evaluate eligibility and calculate benefit amounts accurately.

The parties involved are individuals applying for Social Security benefits and the SSA. The form typically consists of sections for the applicant's personal information, employment details, earnings, and a detailed work history summary. Accurate and thorough completion is important to determine benefit eligibility and amounts correctly.