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The SSA SS-5 form is an important document that individuals use to apply for a Social Security Number (SSN), a crucial identifier for various services and benefits in the United States. This form plays a significant role in the lives of citizens and residents alike, as it is often required for employment, filing taxes, and accessing government assistance programs. Completing the SS-5 form involves providing personal details such as your name, date of birth, and place of birth, along with information about your immigration status if you are not a U.S. citizen. For those applying on behalf of a child or dependent, additional requirements may apply. The process of obtaining an SSN can significantly influence one’s ability to engage in everyday activities like opening a bank account or securing housing. Before submitting the form, applicants should carefully gather all necessary documentation, which may include proof of identity, citizenship, or legal residency. By understanding the critical aspects of the SSA SS-5 form, individuals can navigate the application process more smoothly, ensuring they meet all requirements set forth by the Social Security Administration.

SSA SS-5 Example

Form SS-5 (11-2019) UF

Page 1 of 5

Discontinue Prior Editions

OMB No. 0960-0066

SOCIAL SECURITY ADMINISTRATION

Application for a Social Security Card

Applying for a Social Security Card is free!

USE THIS APPLICATION TO:

Apply for an original Social Security card

Apply for a replacement Social Security card

Change or correct information on your Social Security number record

IMPORTANT: You MUST provide a properly completed application and the required evidence before we can process your application. We can only accept original documents or documents certified by the custodian of the original record. Notarized copies or photocopies which have not been certified by the custodian of the record are not acceptable. We will return any documents submitted with your application. For assistance call us at 1-800-772-1213 or visit our website at www.socialsecurity.gov.

Original Social Security Card

To apply for an original card, you must provide at least two documents to prove age, identity, and U.S. citizenship or current lawful, work-authorized immigration status. If you are not a U.S. citizen and do not have DHS work authorization, you must prove that you have a valid non-work reason for requesting a card. See page 2 for an explanation of acceptable documents.

NOTE: If you are age 12 or older and have never received a Social Security number, you must apply in person.

Replacement Social Security Card

To apply for a replacement card, you must provide one document to prove your identity. If you were born outside the U.S., you must also provide documents to prove your U.S. citizenship or current, lawful, work-authorized status. See page 2 for an explanation of acceptable documents.

Changing Information on Your Social Security Record

To change the information on your Social Security number record (i.e., a name or citizenship change, or corrected date of birth) you must provide documents to prove your identity, support the requested change, and establish the reason for the change. For example, you may provide a birth certificate to show your correct date of birth. A document supporting a name change must be recent and identify you by both your old and new names. If the name change event occurred over two years ago or if the name change document does not have enough information to prove your identity, you must also provide documents to prove your identity in your prior name and/or in some cases your new legal name. If you were born outside the U.S. you must provide a document to prove your U.S. citizenship or current lawful, work-authorized status. See page 2 for an explanation of acceptable documents.

LIMITS ON REPLACEMENT SOCIAL SECURITY CARDS

Public Law 108-458 limits the number of replacement Social Security cards you may receive to 3 per calendar year and 10 in a lifetime. Cards issued to reflect changes to your legal name or changes to a work authorization legend do not count toward these limits. We may also grant exceptions to these limits if you provide evidence from an official source to establish that a Social Security card is required.

IF YOU HAVE ANY QUESTIONS

If you have any questions about this form or about the evidence documents you must provide, please visit our website at www.socialsecurity.gov for additional information as well as locations of our offices and Social Security Card Centers. You may also call Social Security at 1-800-772-1213. You can also find your nearest office or Card Center in your local phone book.

Form SS-5 (11-2019) UF

Page 2 of 5

EVIDENCE DOCUMENTS

The following lists are examples of the types of documents you must provide with your application and are not all inclusive. Call us at 1-800-772-1213 if you cannot provide these documents.

IMPORTANT : If you are completing this application on behalf of someone else, you must provide evidence that shows your authority to sign the application as well as documents to prove your identity and the identity of the person for whom you are filing the application. We can only accept original documents or documents certified by the custodian of the original record. Notarized copies or photocopies which have not been certified by the custodian of the record are not acceptable.

Evidence of Age

In general, you must provide your birth certificate. In some situations, we may accept another document that shows your age. Some of the other documents we may accept are:

U.S. hospital record of your birth (created at the time of birth)

Religious record established before age five showing your age or date of birth

Passport

Final Adoption Decree (the adoption decree must show that the birth information was taken from the original birth certificate)

Evidence of Identity

You must provide current, unexpired evidence of identity in your legal name. Your legal name will be shown on the Social Security card. Generally, we prefer to see documents issued in the U.S. Documents you submit to establish identity must show your legal name AND provide biographical information (your date of birth, age, or parents' names) and/or physical information (photograph, or physical description - height, eye and hair color, etc.). If you send a photo identity document but do not appear in person, the document must show your biographical information (e.g., your date of birth, age, or parents' names). Generally, documents without an expiration date should have been issued within the past two years for adults and within the past four years for children.

As proof of your identity, you must provide a:

U.S. driver's license; or

U.S. State-issued non-driver identity card; or

U.S. passport

If you do not have one of the documents above or cannot get a replacement within 10 work days, we may accept other documents that show your legal name and biographical information, such as a U.S. military identity card, Certificate of Naturalization, employee identity card, certified copy of medical record (clinic, doctor or hospital), health insurance card, Medicaid card, or school identity card/record. For young children, we may accept medical records (clinic, doctor, or hospital) maintained by the medical provider. We may also accept a final adoption decree, or a school identity card, or other school record maintained by the school.

If you are not a U.S. citizen, we must see your current U.S. immigration document(s) and your foreign passport with biographical information or photograph.

WE CANNOT ACCEPT A BIRTH CERTIFICATE, HOSPITAL SOUVENIR BIRTH CERTIFICATE, SOCIAL SECURITY CARD STUB OR A SOCIAL SECURITY RECORD as evidence of identity.

Evidence of U.S. Citizenship

In general, you must provide your U.S. birth certificate or U.S. Passport. Other documents you may provide are a Consular Report of Birth, Certificate of Citizenship, or Certificate of Naturalization.

Evidence of Immigration Status

You must provide a current unexpired document issued to you by the Department of Homeland Security (DHS) showing your immigration status, such as Form I-551, I-94, or I-766. If you are an international student or exchange visitor, you may need to provide additional documents, such as Form I-20, DS-2019, or a letter authorizing employment from your school and employer (F-1) or sponsor (J-1). We CANNOT accept a receipt showing you applied for the document. If you are not authorized to work in the U.S., we can issue you a Social Security card only if you need the number for a valid non-work reason. Your card will be marked to show you cannot work and if you do work, we will notify DHS. See page 3, item 5 for more information.

Form SS-5 (11-2019) UF

Page 3 of 5

HOW TO COMPLETE THIS APPLICATION

Complete and sign this application LEGIBLY using ONLY black or blue ink on the attached or downloaded form using only 8 ½” x 11” (or A4 8.25” x 11.7”) paper.

GENERAL: Items on the form are self-explanatory or are discussed below. The numbers match the numbered items on the form. If you are completing this form for someone else, please complete the items as they apply to that person.

4.Show the month, day, and full (4 digit) year of birth; for example, “1998” for year of birth.

5.If you check “Legal Alien Not Allowed to Work” or “Other,” you must provide a document from a U.S. Federal, State, or local government agency that explains why you need a Social Security number and that you meet all the requirements for the government benefit. NOTE: Most agencies do not require that you have a Social Security number. Contact us to see if your reason qualifies for a

Social Security number.

6., 7. Providing race and ethnicity information is voluntary and is requested for informational and statistical purposes only. Your choice whether to answer or not does not affect decisions we make on your application. If you do provide this information, we will treat it very carefully.

9.B., 10.B. If you are applying for an original Social Security card for a child under age 18, you MUST show the parents' Social Security numbers unless the parent was never assigned a Social Security number. If the number is not known and you cannot obtain it, check the “unknown” box.

13.If the date of birth you show in item 4 is different from the date of birth currently shown on your Social Security record, show the date of birth currently shown on your record in item 13 and provide evidence to support the date of birth shown in item 4.

16.Show an address where you can receive your card 7 to 14 days from now.

17.WHO CAN SIGN THE APPLICATION? If you are age 18 or older and are physically and mentally capable of reading and completing the application, you must sign in item 17. If you are under age 18, you may either sign yourself, or a parent or legal guardian may sign for you. If you are over age 18 and cannot sign on your own behalf, a legal guardian, parent, or close relative may generally sign for you. If you cannot sign your name, you should sign with an "X” mark and have two people sign as witnesses in the space beside the mark. Please do not alter your signature by including additional information on the signature line as this may invalidate your application. Call us if you have questions about who may sign your application.

HOW TO SUBMIT THIS APPLICATION

In most cases, you can take or mail this signed application with your documents to any Social Security office. Any documents you mail to us will be returned to you. Go to https://secure.ssa.gov/apps6z/FOLO/fo001.jsp to find the Social Security office or Social Security Card Center that serves your area.

Form SS-5 (11-2019) UF

Page 4 of 5

PROTECT YOUR SOCIAL SECURITY NUMBER AND CARD

Protect your SSN card and number from loss and identity theft. DO NOT carry your SSN card with you. Keep it in a secure location and only take it with you when you must show the card; e.g., to obtain a new job, open a new bank account, or to obtain benefits from certain U.S. agencies. Use caution in giving out your Social Security number to others, particularly during phone, mail, email and Internet requests you did not initiate.

PRIVACY ACT STATEMENT

Collection and Use of Personal Information

Sections 205(c) and 702 of the Social Security Act, as amended, allow us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent us from assigning you a Social Security number (SSN) and issuing you a new or replacement Social Security card.

We will use the information to assign you an SSN and issue you a new or replacement Social Security card. We may also share your information for the following purposes, called routine uses:

To Federal, State, and local entities to assist them with administering income maintenance and health maintenance programs, when a Federal statute authorizes them to use the SSN; and,

To the Department of State for administering the Social Security Act in foreign countries through its facilities and services.

In addition, we may share this information in accordance with the Privacy Act and other Federal laws. For example, where authorized, we may use and disclose this information in computer matching programs, in which our records are compared with other records to establish or verify a person's eligibility for Federal benefit programs and for repayment of incorrect or delinquent debts under these programs.

A list of additional routine uses is available in our Privacy Act System of Records Notice (SORN) 60-0058, entitled Master Files of Social Security Number (SSN) Holders and SSN Applications, as published in the Federal Register (FR) on December 29, 2010, at 75 FR 82121. Additional information, and a full listing of all of our SORNs, is available on our website at www.ssa.gov/privacy.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 8.5 to 9.5 minutes to read the instructions, gather the facts, and answer the questions. SEND OR BRING THE COMPLETED

FORM TO YOUR LOCAL SOCIAL SECURITY OFFICE. You can find your local Social Security office through SSA's website at www.socialsecurity.gov. Offices are also listed under U. S. Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You may send

comments on our time estimate above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401. Send only

comments relating to our time estimate to this address, not the completed form.

Form SS-5 (11-2019) UF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 5 of 5

Discontinue Prior Editions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SOCIAL SECURITY ADMINISTRATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OMB No. 0960-0066

 

 

 

 

 

 

Application for a Social Security Card

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

 

First

 

 

 

 

 

 

 

Full Middle Name

 

 

 

 

 

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

1

TO BE SHOWN ON CARD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FULL NAME AT BIRTH

 

First

 

 

 

 

 

 

 

Full Middle Name

 

 

 

 

 

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

IF OTHER THAN ABOVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER NAMES USED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Social Security number previously assigned to the person

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

listed in item 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

PLACE OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Office

 

4

 

DATE

 

 

 

 

 

 

 

 

 

 

 

BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Use Only

 

 

OF

 

 

 

 

 

 

 

 

 

 

 

(Do Not Abbreviate)

City

 

 

 

 

 

 

State or Foreign Country

 

 

 

 

FCI

 

 

BIRTH

 

 

 

 

 

 

MM/DD/YYYY

5

CITIZENSHIP

 

 

 

 

U.S. Citizen

 

Legal Alien

 

 

 

Legal Alien Not Allowed To

 

 

 

 

Other (See

 

 

 

 

 

Allowed To

 

 

 

Work(See Instructions On

 

 

 

 

Instructions On

 

(Check One)

 

 

 

 

 

 

 

 

 

 

 

 

Work

 

 

 

 

 

 

Page 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 3)

 

ETHNICITY

 

 

 

 

 

 

 

RACE

 

 

 

 

 

 

 

Native Hawaiian

 

 

American Indian

 

 

Other Pacific

6

Are You Hispanic or Latino?

 

7

 

Select One or More

 

 

 

Alaska Native

 

 

Black/African

 

 

 

 

 

 

Islander

(Your Response is Voluntary)

 

 

(Your Response

 

 

 

 

 

 

 

 

 

 

 

White

 

Yes

No

 

 

 

 

is Voluntary)

 

 

 

Asian

 

 

 

 

 

 

 

 

 

 

American

 

 

 

 

 

 

 

 

 

 

 

8

SEX

 

 

 

 

 

 

 

 

 

 

 

Male

 

 

 

 

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. PARENT/ MOTHER'S

 

 

 

First

 

 

 

 

 

 

 

 

 

Full Middle Name

 

 

 

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

NAME AT HER BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. PARENT/ MOTHER'S SOCIAL SECURITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER (See instructions for 9B on Page 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. PARENT/ FATHER'S

 

 

 

First

 

 

 

 

 

 

 

 

 

 

Full Middle Name

 

 

 

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

10

NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. PARENT/ FATHER'S SOCIAL SECURITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER (See instructions for 10B on Page 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

Has the person listed in item 1 or anyone acting on his/her behalf ever filed for or received a Social Security number card

before?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Don't Know (If "don't know," skip to question 14.)

 

Yes (If "yes" answer questions 12-13)

 

No

 

 

 

 

 

12

Name shown on the most recent Social

 

First

 

 

 

 

 

 

 

 

 

 

 

Full Middle Name

Last

 

 

 

 

 

 

Security card issued for the person

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

listed in item 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

Enter any different date of birth if used on an

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

earlier application for a card

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM/DD/YYYY

 

 

 

 

 

 

 

 

 

 

 

14

DATETODAY'S

 

 

 

 

 

 

 

 

15

NUMBERDAYTIME PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM/DD/YYYY

 

 

 

 

 

 

Area Code

 

Number

 

 

 

 

 

 

 

 

 

 

16

MAILING ADDRESS

Street

Address,

Apt. No., PO Box, Rural

 

Route No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

State/Foreign Country

 

 

 

 

 

 

 

 

ZIP Code

 

(Do Not Abbreviate)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I declare under penalty of perjury that I have examined all the information on this form, and on any accompanying

17

statements or forms, and it is true and correct to the best of my knowledge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR SIGNATURE

 

 

 

 

 

 

18

YOUR RELATIONSHIP TO THE PERSON IN ITEM 1 IS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Self

Natural Or

 

 

 

Legal

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adoptive Parent

 

 

 

Guardian

 

 

 

Specify

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DO NOT WRITE BELOW THIS LINE (FOR SSA USE ONLY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NPN

 

 

 

 

 

 

 

 

 

 

 

 

DOC

 

 

NTI

 

 

 

 

 

 

 

CAN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ITV

PBC

 

EVI

 

EVA

 

 

 

 

 

 

EVC

 

 

 

PRA

 

 

 

 

NWR

 

 

DNR

 

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EVIDENCE SUBMITTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE AND TITLE OF EMPLOYEE(S)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REVIEWING EVIDENCE AND/OR CONDUCTING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTERVIEW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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DCL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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File Breakdown

Fact Name Description
Purpose The SSA SS-5 form is used to apply for a Social Security card, including obtaining a new card, replacing a lost card, or updating information.
Eligibility Anyone can apply for a Social Security card when they are born, when they change their name, or when they require a new card due to loss or theft.
Required Information The form requires personal details such as name, date of birth, place of birth, and parents' names and Social Security numbers, if applicable.
Submission The completed form can be submitted online or taken to your local Social Security Administration office, along with the necessary supporting documents.

Guide to Using SSA SS-5

Filling out the SSA SS-5 form is a necessary step in applying for a Social Security Number. Completing this form accurately ensures that your application can be processed effectively. Below are step-by-step instructions designed to guide you through this task.

  1. Begin by downloading the SSA SS-5 form from the Social Security Administration's official website, or obtain a physical copy from your local Social Security office.
  2. At the top of the form, clearly print your full name in the designated field. If you have obtained a legal name change, ensure you provide your previous name as well.
  3. In the next section, enter your Social Security Number if you have one. If you are applying for a new number, leave this blank.
  4. Provide your date of birth. Use the format specified in the form, typically MM/DD/YYYY.
  5. Indicate your place of birth. This should include the city, state, and country.
  6. Fill in the fields for your parent's information. Include their names, Social Security Numbers (if known), and their places of birth.
  7. In the section regarding your gender, select the appropriate box to identify your gender as male or female.
  8. Complete your current address, ensuring to include your street name, house number, city, state, and ZIP code.
  9. Provide your phone number, including the area code, in the space provided.
  10. In the final section of the form, you will affirm that the information you provided is true. Sign and date the form.

Once you have completed these steps, review the form carefully for any errors or omissions. Make sure to attach any required documents, such as proof of identity or citizenship. Afterward, you can submit your completed form to the Social Security Administration either by mail or in person, depending on your preference. Keep a copy for your records, as it may be useful in the future.

Get Answers on SSA SS-5

What is the SSA SS-5 form?

The SSA SS-5 form is an application for a Social Security card. It is used by individuals to request a new card, to replace a lost or damaged card, or to update personal information such as a name change. The Social Security Administration (SSA) processes this form and issues Social Security cards based on the information provided.

Who needs to fill out the SSA SS-5 form?

Individuals of all ages may need to complete the SSA SS-5 form. This includes:

  • Newborns who require a Social Security number.
  • Adults who have lost their Social Security card.
  • Individuals who have legally changed their name.
  • Non-citizens who need to apply for work authorization.

Each of these situations necessitates accurately filling out this form to ensure that the correct information is reported to the SSA.

What information is required on the SSA SS-5 form?

The SSA SS-5 form requests several pieces of important information, including:

  1. Your name as it appears on your birth certificate or other legal documents.
  2. Your Social Security number if you have previously been issued one.
  3. Your date and place of birth.
  4. Your citizenship status or immigration information if applicable.
  5. Your parents’ names and Social Security numbers (if known).

Providing accurate information helps prevent delays in processing the application.

How can someone submit the SSA SS-5 form?

The SSA SS-5 form can be submitted in several ways:

  • By mailing the completed form to the address designated for your state.
  • By visiting a local Social Security office in person. It is advisable to schedule an appointment to minimize wait times.
  • For certain situations, individuals may also be able to apply online, particularly for replacement cards.

It is important to review the SSA’s official website for specific instructions based on your circumstances and location.

What should someone do if they make a mistake on the SSA SS-5 form?

If a mistake is made on the SSA SS-5 form, the process to correct it depends on whether the form has been submitted. If the form has not yet been submitted, individuals should simply correct the error and ensure all information is accurate before submission. If the form has already been submitted, it is advisable to contact the SSA directly to discuss the necessary steps for correction. Promptly addressing mistakes can help avoid potential issues with the issuance of the Social Security card.

Common mistakes

Filling out the SSA SS-5 form correctly is essential for obtaining a Social Security number. However, many people make common mistakes that can delay the process. Understanding these pitfalls can help streamline your application.

One frequent mistake is not using the correct name. Applicants sometimes fill out the form with a nickname or a variation of their legal name. It's important to use the name exactly as it appears on your birth certificate or legal documents to avoid confusion.

Another common error is omitting required information. The SSA SS-5 form requires specific details like date and place of birth, parents’ names, and addresses. Leaving blank spaces can cause processing delays or even denial of the application.

Some people fail to double-check their SSN application for accuracy. Small typographical errors, like wrong digits in your Social Security number, can lead to significant problems. It’s worth taking a moment to review your entries before submitting the form.

Furthermore, missing signatures is a common oversight. Applicants often forget to sign the SS-5 form, which is crucial for processing. A signature indicates consent and verifies the information provided is accurate.

If you’re applying on behalf of someone else, not providing proper identification can be problematic. Your application must include valid proof if you’re acting on behalf of a child or someone who cannot complete the form themselves.

Another mistake many make is submitting outdated versions. The SSA occasionally updates its forms. Using an old version can lead to rejections. Always ensure you’re using the latest version of the SS-5.

Some applicants also misunderstand the eligibility criteria. The reasons for needing a Social Security number can vary, and it’s essential to clearly state the purpose in your application. Not providing this information can slow down the review process.

For some, including unnecessary documentation is a typical mistake. While providing additional information may seem helpful, it can complicate the application. Stick to the required documents only; keep it simple.

Not keeping a copy of your application is another common practice. Having a copy enables you to track your application’s status and provides a reference point if any issues arise. Always make sure to retain a completed copy before mailing or submitting your application.

Lastly, many applicants overlook the timing of submission. Whether you need your SSN for a job or school, understanding the processing times is important. Patience is key, but it's also wise to apply early to avoid last-minute stress.

By being aware of these common errors, you can proactively ensure that your SSA SS-5 form is completed correctly, helping you to secure your Social Security number without unnecessary delays.

Documents used along the form

When applying for a Social Security card or making adjustments to your record, the SSA SS-5 form is commonly required. However, other forms and documents often accompany this process to ensure that your application is complete and accurate. Here’s a brief overview of the additional documents that may be necessary.

  • Proof of Identity: This could include a U.S. driver's license, state-issued ID, or a U.S. passport. This document verifies your identity and helps prevent identity theft.
  • Proof of Age: Typically required for newborns and children applying for a Social Security number, this can be shown through a birth certificate or other reliable documents that establish age.
  • Proof of Citizenship or Immigration Status: Acceptable documents include a U.S. passport, Certificate of Naturalization, or immigration documents if you are not a U.S. citizen. These help clarify your eligibility for a Social Security number.
  • Application for Replacement Social Security Card: This may need to be filled out if you are replacing a lost or stolen card. Form SS-5 is typically used alongside this application for a comprehensive request.
  • Signed Social Security Waiver: In certain cases, you might need to provide consent waiving privacy rights for information sharing between agencies related to benefits or services.

Gathering the necessary documents can streamline the application process, ensuring no delays due to missing information. Being prepared allows you to navigate your Social Security needs efficiently.

Similar forms

The SSA SS-5 form is used to apply for a Social Security Number (SSN). Several other forms and documents share similarities with the SS-5 in terms of purpose, information required, or the process of application. Below is a list of nine such documents:

  • US Passport Application (Form DS-11) - Like the SS-5, this form collects personal information, such as identity and citizenship status, to establish a person's identity in order to obtain an official identification document.
  • State ID Application - This document is used to apply for a state-issued identification card, similar to the SS-5, as both require proof of identity and residency.
  • Birth Certificate Application - This form is often necessary to establish citizenship or identity, paralleling the SS-5's role in securing a Social Security Number.
  • Driver's License Application - Just as the SS-5 is needed for an SSN, a driver's license application requires personal identification and documentation to verify the applicant’s identity.
  • Voter Registration Application - This document collects personal data from the applicant, similar to the SS-5, in order to verify eligibility and facilitate participation in elections.
  • Medicare Application - Individuals apply for Medicare using a form that requires similar demographic and health-related information, akin to what is needed on the SS-5.
  • Employment Authorization Document (Form I-765) - This application also involves the submission of personal information and proof of identity, relating closely to the information required by the SS-5.
  • Naturalization Application (Form N-400) - This document collects extensive personal information to screen eligibility for US citizenship, similar to the SS-5's purpose regarding Social Security.
  • Taxpayer Identification Number Application (Form W-7) - Used for obtaining an Individual Taxpayer Identification Number, this form also gathers personal information necessary for identification, akin to the SS-5.

Dos and Don'ts

Filling out the SSA SS-5 form, which is used to apply for a Social Security number, requires careful attention. To help ensure the process goes smoothly, here are some important do's and don'ts to consider.

  • Do provide accurate and complete information. Any discrepancies may delay your application.
  • Do double-check your spelling, especially for names and addresses. Mistakes can create confusion.
  • Do use your legal name as it appears on your birth certificate or other legal documents.
  • Do include your Social Security number if you have one, even if it’s for another family member.
  • Do review the eligibility criteria for obtaining a Social Security number before submitting your application.
  • Don't leave any sections of the form blank. All applicable areas need to be filled out.
  • Don't use white-out or correction fluid for mistakes. It can be better to simply cross out errors and write the correct information.
  • Don't submit photocopied documents unless instructed. Original documents may be required for verification.
  • Don't rush through the process. Taking your time can help avoid errors and future complications.

By following these guidelines, you can make the process of completing the SSA SS-5 form more efficient and less stressful. Taking careful steps now can help you avoid potential issues later on.

Misconceptions

The SSA SS-5 form is an important document used to apply for a Social Security number (SSN). However, many people misunderstand its purpose and requirements. Below are eight common misconceptions about the SSA SS-5 form, along with clarifications.

  1. Only U.S. citizens need to apply for an SSN. Many believe that only citizens are eligible for a Social Security number. In reality, lawful permanent residents and certain non-citizens can also apply for an SSN.
  2. The SS-5 form can be submitted online. Some people think they can complete and submit the SS-5 form online. However, this form must be submitted in person or via mail, depending on the applicant's circumstances.
  3. There is no need to provide documentation with the SS-5 form. It's a common belief that the SS-5 form can be submitted without supporting documents. Applicants must provide proof of identity, age, and, in some cases, citizenship or immigration status.
  4. All applications require a fee. Many assume that applying for an SSN incurs a cost. The application for an SSN itself is free of charge.
  5. Once an SSN is issued, it cannot be changed. Some people think that an SSN is permanent and unchangeable. In certain situations, such as identity theft, the Social Security Administration (SSA) may permit a number change.
  6. Providing false information on the form has no consequences. There is a misconception that submitting false information will go unnoticed. In truth, providing inaccurate or misleading information can lead to legal penalties and denial of benefits.
  7. Dependents do not need their own SSN. It is often thought that dependents can use a parent’s SSN. However, dependents must have their own SSN for tax purposes and to access certain benefits.
  8. You can apply for an SSN at any Social Security office. Many believe they can apply for an SSN at any SSA office without regard to location. However, individuals should go to the correct office that serves their specific region.

Understanding these misconceptions can help ensure that applicants have the necessary information to successfully complete the SSA SS-5 form and receive their Social Security number without unnecessary complications.

Key takeaways

  • Complete the form accurately: Ensure all sections are filled out correctly. Double-check names, Social Security numbers, and addresses to avoid delays.
  • Use the right documents: Gather necessary documents that prove your citizenship, identity, and age. Valid documents include a birth certificate and government-issued ID.
  • Submit it in the right way: You can submit the SSA SS-5 form in person at your local Social Security office or by mailing it to the appropriate address. Choose what works best for you.
  • Keep track of your application: After submission, follow up if you don't receive a response within a reasonable time. You can contact the Social Security Administration for updates.