Social Security Forms | Social Security Administration

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The form you are looking for is not available online. Many forms must be completed only by a Social Security Representative. Please call us at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday between 7 a.m. and 7 p.m. or contact your local Social Security office.

Number	Title
SS-5	Application for a Social Security Card In some areas, you may request a replacement Social Security card online.
SSA-561-U2	Request for Reconsideration
SSA-827	Authorization to Disclose Information to the Social Security Administration
SSA-1696-U4	Appointment of Representative
SSA-3820-BK	Disability Report - Child
IRS W-4V	Voluntary Withholding Request
CMS-40B	Application for Enrollment in Medicare - Part B (Medical Insurance)
CMS-L564	Request for Employment Information
CMS-L564S	Solicitud De Información Sobre El Empleo
HA-501-U5	Request for Hearing by Administrative Law Judge
HA-520-U5	Request for Review of Hearing Decision/Order
HA-539	Notice Regarding Substitution of Party Upon Death of Claimant
HA-539-SP	Aviso Sobre La Substitución De La Parte Interesada Tras El Fallecimiento Del Reclamante
HA-4608	Waiver of Your Right to Personal Appearance Before an Administrative Law Judge
HA-4631	Claimant's Recent Medical Treatment
HA-4632	Claimant's Medications
HA-4633	Claimant's Work Background
IRS SS-4	Application for Employer Identification Number
Online	Adult Disability Report
Online	Appeal a Recent Medical Decision
Online	Apply for Disability Benefits
Online	Apply for Retirement, Spouse's or Medicare Benefits
Online	Apply Online for Extra Help with Medicare Prescription Drug Plan Costs
Online	Change Address or Telephone Number
Online	Child Disability Report
Online	Get a Replacement Medicare Card
Online	Representative Payee Accounting Report
Online	Request a Form SSA-1099/1042 (Benefit Statement) for tax or other purposes
Online	Request a Proof of Social Security Benefits Letter
Online	Request Special Notices for the Blind or Visually Impaired
Online	Sign Up For or Change Direct Deposit
SF-1199A	Direct Deposit Sign-Up Form
SS-5-FS	Application for a Social Security Card (Outside of the U.S.)
SS-5-SP	Solicitud para una tarjeta de Seguro Social
SSA-1-BK	Application for Retirement Insurance Benefits
SSA-2-BK	Application for Wife's or Husband's Insurance Benefits
SSA-3	Marriage Certification
SSA-4-BK	Application for Child's Insurance Benefits
SSA-4-BK-SP	Solicitud Para Beneficios De Seguro Para Niños
SSA-4-INST	Reporting Responsibilities for Child's Insurance Benefits
SSA-5-BK	Application for Mother's or Father's Insurance Benefits
SSA-5-INST	Reporting Responsibilities for Mother's or Father's Insurance Benefits
SSA-7-F6	Application for Parent's Insurance Benefits
SSA-8	Application for Lump-Sum Death Payment
SSA-10	Application for Widow's or Widower's Insurance Benefits
SSA-10-BK-SP	Solicitud Para Beneficios De Seguro De Viuda O Viudo
SSA-10-INST	Reporting Responsibilities for Widow's or Widower's Insurance Benefits
SSA-16-BK	Application for Disability Insurance Benefits
SSA-16-BK-SP	Solicitud para beneficios de seguro por incapacidad
SSA-16-INST	Reporting Responsibilities For Disability Insurance Benefits
SSA-21	Supplement to Claim of Person Outside the United States
SSA-24	Application for Survivors Benefits (Payable Under Title II of the Social Security Act)
SSA-25	Certification of Election for Reduced Spouse's Benefits
SSA-44	Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event
SSA-88	Pre-Approval Form for Consent Based Social Security Number Verification (CBSV)
SSA-89	Authorization for the Social Security Administration To Release Social Security Number (SSN) Verification
SSA-89-SP	Autorización para que la Administración de Seguro Social Divulgue la Verificación de un Número de Seguro Social (SSN)
SSA-131	Employer Report of Special Wage Payments
SSA-150	Modified Benefits Formula Questionnaire
SSA-199	Vocational Rehabilitation Provider Claim
SSA-308	Modified Benefits Formula Questionnaire, Foreign Pension
SSA-437-BK	Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration
SSA-437-BK-SP	Formulario Para Querellas De Alegaciones De Discriminación En Los Programas De La Administración Del Seguro Social
SSA-521	Request for Withdrawal of Application
SSA-545-BK	Plan for Achieving Self-Support
SSA-546	Worker's Compensation/Public Disability Questionnaire
SSA-604	Certificate of Incapacity
SSA-623-F6	Representative Payee Report Not available online - contact your local Social Security office
SSA-632-BK	Request for Waiver of Overpayment Recovery or Change in Repayment Rate
SSA-640	Financial Disclosure for Civil Monetary Penatly (CMP) Debt
SSA-671	Railroad Employment Questionnaire
SSA-711	Request for Deceased Individual's Social Security Record
SSA-714	You can make your payment by Credit Card
SSA-721	Statement of Death by Funeral Director
SSA-753	Statement Regarding Marriage
SSA-754-F4	Statement of Marital Relationship
SSA-769-U4	Request for Change in Time/Place of Disability Hearing
SSA-770-U4	Notice Regarding Substitution of Party Upon Death of Claimant Reconsideration of Disability Cessation
SSA-773-U4	Waiver Of Right To Appear - Disability Hearing
SSA-781	Certificate of Responsibility for Welfare and Care of Child
SSA-783	Statement Regarding Contributions
SSA-788	Statement of Care and Responsibility for Beneficiary
SSA-789-U4	Request for Reconsideration - Disability Cessation
SSA-795	Statement of Claimant or Other Persons
SSA-820-BK	Work Activity Report (Self-Employed Person)
SSA-821-BK	Work Activity Report
SSA-827-INST	Instructions for Completing the SSA-827
SSA-827-INST-SP	Instrucciones para completar el formulario SSA-827
SSA-1020-INST	General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1020B-OCR-SM-INST	Instrucciones generales para llenar la Solicitud para el Beneficio Adicional con los gastos del plan de medicamentos recetados de Medicare
SSA-1021	Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1021-SP	Apelación de la determinación para recibir el Beneficio Adicional con los gastos del plan de medicamentos recetados de Medicare
SSA-1021-INST	Instructions for Completing the Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs
SSA-1021-INST-SP	Instrucciones para llenar la apelación de la determinación para recibir el beneficio adicional con los gastos del plan de medicamentos recetados de Medicare
SSA-1199	International Direct Deposit (IDD)
SSA-1372-BK	Advanced Notice of Termination of Child's Benefits
SSA-1372-BK-FC	Advanced Notice of Termination of Child's Benefits (Foreign Claims)
SSA-1383	Student Reporting Form
SSA-1383-FC	Reporting to Social Security Administration by Student Outside the United States
SSA-1414	Credit Card Payment Form
SSA-1560-U4	Petition For Authorization To Charge And Collect A Fee For Services Before The Social Security Administration
SSA-1694	Request for Business Entity Taxpayer Information
SSA-1695-F3	Identifying Information for Possible Direct Payment of Authorized Fees
SSA-1699	Registration for Appointed Representative Services and Direct Payment
SSA-1724-F4	Claim for Amounts due in case of a Deceased Beneficiary
SSA-1945	Statement Concerning Your Employment in a Job Not Covered by Social Security
SSA-2000-F6	Application for Special Benefits for World War II Veterans
SSA-2010-F6	Statement for Determining Continuing Entitlement for Special Veterans Benefits (SVB)
SSA-2032-BK	Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate
SSA-2512	Pre-1957 Military Service Federal Benefit Questionnaire
SSA-2519	Child Relationship Statement
SSA-2855	Statement of Funds you Received
SSA-3033	Employee Work Activity Questionnaire
SSA-3105	Important information about your appeal, waiver rights, and repayment options
SSA-3288	Consent for Release of Information
SSA-3288-SP	Consentimiento para divulgar información
SSA-3368-BK	Disability Report - Adult
SSA-3369-BK	Work History Report
SSA-3373-BK	Function Report - Adult
SSA-3375-BK	Function Report - Child Birth to 1st Birthday
SSA-3376-BK	Function Report - Child Age 1 to 3rd Birthday
SSA-3377-BK	Function Report - Child Age 3 to 6th Birthday
SSA-3378-BK	Function Report - Child Age 6 to 12th Birthday
SSA-3379-BK	Function Report - Child Age 12 to 18th Birthday
SSA-3380-BK	Function Report - Adult - Third Party Form
SSA-3441-BK	Disability Report - Appeal
SSA-3881-BK	Questionnaire for Children Claiming SSI Benefits
SSA-3885	Government Pension Questionnaire
SSA-4111	Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits
SSA-4162	Child Care Dropout Questionnaire
SSA-4814	Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
SSA-4815	Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
SSA-5665-BK	Teacher Questionnaire
SSA-5666	Request for Administrative Information
SSA-7008	Request for Correction of Earnings Record
SSA-7050-F4	Request for Social Security Earnings Information
SSA-7104	Partnership Questionnaire
SSA-7156	Farm Self Employment Questionnaire
SSA-7157-F4	Farm Arrangement Questionnaire
SSA-7160	Employment Relationship Questionnaire
SSA-7163	Questionnaire about Employment or Self Employment
SSA-7163A-F4	Supplemental Statement Regarding Farming Activities
SSA-8240	Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers
SSA-8510	Authorization for the Social Security Administration to Obtain Personal Information
SSA-L447	Medicare Savings Programs Eligible Letters
SSA-L447-SP	Cartas para saber si tiene derecho al Programa de ahorros de Medicare
SSA-L706-F3	Letter to Custodian of Birth Records