Form SSA-781. Certificate of Responsibility for Welfare and Care of Child
Form SSA-781, the Certificate of Responsibility for Welfare and Care of Child, serves as a statement confirming the responsible party's commitment to the welfare and care of a child. It is used for matters related to child benefits.
Form SSA-604. Certificate of Incapacity
Form SSA-604, the Certificate of Incapacity, serves as a medical certificate for individuals who are unable to manage their own Social Security benefits due to a mental or physical incapacity.
Form SSA-561-U2. Request for Reconsideration
Form SSA-561-U2, the Request for Reconsideration, serves as a formal request by individuals who have been denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits and wish to appeal the decision.
Form SSA-5062. Claimant's Statement about Loan of Food or Shelter
Form SSA-5062, Claimant's Statement about the Loan of Food or Shelter, is used to collect information from Supplemental Security Income (SSI) applicants or beneficiaries regarding the receipt of food or shelter.
Form SSA-632-BK. Request for Waiver of Overpayment Recovery
Form SSA-632-BK, issued by the Social Security Administration, is used for the purpose of requesting a waiver of overpayment recovery.
Form SSA-634. Request for Change in Overpayment Recovery Rate
Form SSA-634, the Request for Change in Overpayment Recovery Rate, serves as a request for individuals to adjust the rate at which the Social Security Administration (SSA) recovers overpaid benefits.
Form SSA-5-BK. Application for Mother's or Father's Insurance Benefits
Form SSA-5-BK, the Application for Mother's or Father's Insurance Benefits, serves as the formal application for individuals to claim insurance benefits based on the work history of their parents.
Form SSA-5665-BK. Teacher Questionnaire
Form SSA-5665-BK, the Teacher Questionnaire, is used to collect information from educators about a student's ability to function independently due to a physical or mental condition.
Form SSA-5-INST. Reporting Responsibilities for Mother's or Father's Insurance Benefits
Form SSA-5-INST, the Reporting Responsibilities for Mother's or Father's Insurance Benefits, provides instructions for individuals who are applying for Mother's or Father's Insurance Benefits.
Form SSA-546. Worker's Compensation/Public Disability Questionnaire
Form SSA-546, the Worker's Compensation/Public Disability Questionnaire, serves as a tool to gather information regarding a claimant's receipt of workers' compensation or public disability benefits.