Form SSA-3377-BK, the Function Report for Children from Age 3 to 6th Birthday, serves as a questionnaire for parents or guardians to provide detailed information about a child's abilities, developmental milestones, and any impairments or delays in development between the ages of 3 and their 6th birthday. The primary purpose of this form is to assist the SSA in evaluating disability claims on behalf of children.
Form SSA-3376-BK is the Function Report for Children from Age 1 to 3rd Birthday. The main purpose of this form is to collect information about a child's development and functioning between their first and third birthdays. It is used by parents or guardians to report on their child's abilities, milestones, and any impairments or delays in development.
Form SSA-3375-BK is the Function Report for Children from Birth to 1st Birthday. The primary purpose of this form is to collect information about a child's development and functioning during their first year of life. It is used by parents or guardians to report on their child's abilities and any impairments or delays in development.
Form SSA-3373-BK, the Function Report for Adults, serves as a detailed questionnaire that adults with disabilities or impairments can use to describe their abilities and limitations in daily activities. The primary purpose of this form is to gather information about an individual's physical and mental functioning to assist the Social Security Administration (SSA) in evaluating disability claims.
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.
Form SSA-3288 is the Consent for Release of Information. Its primary purpose is to authorize the SSA to release an individual's personal and confidential information to designated third parties, such as healthcare providers, attorneys, or other organizations. The form allows individuals to specify who can receive their information and the purpose of the disclosure.
Form SSA-3105, titled "Important Information about Your Appeal, Waiver Rights, and Repayment Options," is a notice provided by the Social Security Administration to individuals who are involved in an appeal or overpayment situation. The main purpose of this form is to inform individuals about their rights, options, and obligations in the context of appeals, overpayments, and potential repayments of benefits.
Form SSA-308 serves as the Modified Benefits Formula Questionnaire for Foreign Pension. The main purpose of this form is to collect information about foreign pension payments received by Social Security recipients. This information is used to determine the impact of foreign pensions on Social Security benefits.
Form SSA-3 is the Marriage Certification. The main purpose of this form is to document and certify a marriage for Social Security benefit purposes. It is used to establish the legal validity of a marriage when individuals are applying for benefits as a spouse or surviving spouse.
Form SSA-2-BK, the Application for Wife's or Husband's Insurance Benefits, is used by individuals who are eligible for Social Security benefits based on their spouse's work record. The main purpose of this form is to allow spouses to apply for benefits based on their husband's or wife's earnings and work history.
