Form SSA-2853-OP4. Message From Social Security - 10 Weeks
Form SSA-2853-OP4 is the Message From Social Security - 10 Weeks. This form serves as a notice from the Social Security Administration to inform individuals that their Social Security benefits will be stopped in 10 weeks unless they provide evidence that they are still eligible for benefits.
Form SSA-268. Patient Acknowledgement Form for Influenza Vaccination
Form SSA-268, the Patient Acknowledgment Form for Influenza Vaccination, is used to acknowledge receipt of the influenza vaccine by patients in healthcare facilities.
Form SSA-3881-BK. Questionnaire for Children Claiming SSI Benefits
Form SSA-3881-BK, the Questionnaire for Children Claiming SSI Benefits, is a questionnaire for parents or guardians of children claiming Supplemental Security Income (SSI) benefits.
Form SSA-545-BK. Plan for Achieving Self-Support
Form SSA-545-BK, the Plan for Achieving Self-Support, is used by individuals with disabilities to outline their plans for achieving self-support through employment or education.
Form SSA-2855. Statement of Funds you Received
Form SSA-2855 is the Statement of Funds You Received. The main purpose of this form is to document and report any funds received by an individual or household, which may impact their eligibility for certain Social Security benefits.
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-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.
Form SSA-3830. Certification of Low Birth Weight for SSI Eligibility
Form SSA-3830, the Certification of Low Birth Weight for SSI Eligibility, is used to certify the low birth weight of a child for eligibility for Supplemental Security Income (SSI) benefits.
Form SSA-4111. Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits
Form SSA-4111, the Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits, serves as a certification form for individuals who are eligible for widow(er)'s or surviving divorced spouse's benefits but choose to receive a reduced benefit amount.
Form SSA-7050-F4. Request for Social Security Earnings Information
Form SSA-7050-F4 is the Request for Social Security Earnings Information. Its primary purpose is to allow individuals or organizations to request information regarding an individual's Social Security earnings history.