Form SSA-546. Worker's Compensation/Public Disability Questionnaire

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.

Form SSA-5665-BK. Teacher Questionnaire

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-5666. Request for Administrative Information

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-5-BK. Application for Mother's or Father's Insurance 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-5-INST. Reporting Responsibilities for Mother's or Father's Insurance Benefits

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-604. Certificate of Incapacity

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-634. Request for Change in Overpayment Recovery Rate

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-640. Financial Disclosure for Civil Monetary Penatly (CMP) Debt

Form SSA-640. Financial Disclosure for Civil Monetary Penatly (CMP) Debt

Form SSA-640, the Financial Disclosure for Civil Monetary Penalty (CMP) Debt, is used by individuals who owe Civil Monetary Penalty debts to the SSA.

Form SSA-671. Railroad Employment Questionnaire

Form SSA-671. Railroad Employment Questionnaire

Form SSA-671, the Railroad Employment Questionnaire, is used to collect information about an individual's employment history in the railroad industry.

Form SSA-7004. Request for Social Security Statement

Form SSA-7004. Request for Social Security Statement

Form SSA-7004, the Request for Social Security Statement, allows individuals to request a statement that provides an estimate of their Social Security benefits, earnings history, and an overview of the benefits that may be available to them.