Form SSA-454-BK. Continuing Disability Review Report
Form SSA-454-BK, the Continuing Disability Review Report, serves as a report for individuals receiving Social Security disability benefits. Its main purpose is to conduct a continuing disability review (CDR) to assess the current disability status of beneficiaries.
Form SSA-4814. Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
Form SSA-4814, the Medical Report on an Adult with an Allegation of Human Immunodeficiency Virus (HIV) Infection, is used to report medical information regarding an adult who alleges having HIV infection.
Form SSA-4815. Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
Form SSA-4815, the Medical Report on a Child with an Allegation of Human Immunodeficiency Virus (HIV) Infection, is similar to Form SSA-4814 but is designed for children.
Form SSA-4-BK. Application for Child's Insurance Benefits
Form SSA-4-BK, the Application for Child's Insurance Benefits, serves as the application form for child's insurance benefits under the Social Security program.
Form SSA-4-INST. Reporting Responsibilities for Child's Insurance Benefits
Form SSA-4-INST, Reporting Responsibilities for Child's Insurance Benefits, serves as instructions for individuals who are receiving or applying for Child's Insurance Benefits under the Social Security program.
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-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-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-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, 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.