Form SSA-3373-BK. Function Report - Adult
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.
Form SSA-3378-BK. Function Report - Child Age 6 to 12th Birthday
Form SSA-3378-BK, the Function Report for Children Age 6 to 12th 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 6 and their 12th birt
Form SSA-5666. Request for Administrative Information
Form SSA-5666, the Request for Administrative Information, is used to request specific information from organizations, institutions, or government agencies regarding a claimant's disability case.
Form SSA-521. Request for Withdrawal of Application
Form SSA-521, the Request for Withdrawal of Application, serves as a request form for individuals who wish to withdraw their application for Social Security benefits.
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.
Form SSA-7104. Partnership Questionnaire
Form SSA-7104, the Partnership Questionnaire, is used to collect information from partnerships for tax and reporting purposes. The main purpose is to gather essential data to determine an individual's eligibility for Social Security benefits.
Form SSA-4178. Marital Relationship Questionaire
Form SSA-4178, the Marital Relationship Questionnaire, is used to collect information about an individual's marital history and relationships that may affect their eligibility for Social Security benefits.
Form SSA-3377-BK. Function Report - Child Age 3 to 6th Birthday
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 b
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-3820-BK. Disability Report - Child
Form SSA-3820-BK, the Disability Report for Children, serves as a report for parents or guardians to provide detailed information about a child's disability or medical condition.