Benefit Claims Supporting Forms:
SSA-3 Marriage Certification
SSA-11 Request to be Selected as Payee
SSA-21 Supplement to Claim of Person Outside the United States
SSA-25 Certificate of Election for Reduced Spouse’s Benefits
SSA-150 Modified Benefits Formula Questionnaire
SSA-308 Modified Benefits Formula Questionnaire, Foreign Pension
SSA-521 Request for Withdrawal of Application
SSA-546 Worker’s Compensation/Public Disability Questionaire
SSA-604 Certificate of Incapacity
SSA-671 Railroad Employment Questionnaire
SSA-723 Statement Regarding the Inferred Death of an Individual
SSA-754 Statement of Marital Relationship
SSA-760 Certificate of Support
SSA-781 Certificate of Responsibility for Welfare and Care of Child
SSA-783 Statement Regarding Contributions
SSA-789 Request for Reconsideration – Disability Cessation
SSA-795 Statement of Claimant or Other Persons
SSA-820-F4 Work Activity Report (Self-Employment Person)
SSA-821-BK Work Activity Report
SSA-827 Authorizations to Disclose Information to SSA
SSA-1372-BK Advance Notice of Termination of Child’s Benefits
SSA-2032-BK Request for Waiver of Special Veterans Benefits (SVB)
SSA-2512 Pre-1957 Military Service Federal Benefit Questionaire
SSA-2519 Child Relationship Statement
SSA-3369 Work History Report
SSA-3441-BK Disability Report-Appeal
SSA-3820 Disability Report Child
SSA-3881 Questionaire for Children Claiming SSI Benefits
SSA-3885 Government Pension Questionaire
SSA-4111 Certificate of Election for Reduced Widow’s or Widower’s Benefits
SSA-4162 Child Care Dropout Questionaire
SSA-4184 Self Employment Corporate Officer Questionaire
SSA-5665-BK Teacher Questionaire
SSA-5666 Request for Administrative Information
SSA-7008 Request for Correction of Earnings Record
SSA-7104 Partnership Questionaire
SSA-7156 Farm Self Employment Questionaire
SSA-7157 Farm Arrangement Questionaire
SSA-7163 Questionaire About Employment or Self Employment
SSA-7163A Supplemental Statement Regarding Farming Activities
