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ON OR PERSONS ABOUT WHOM REPORT IS MADE SOCIAL SECURITY CLAIM NUMBER ON WHICH BENEFITS ARE PAID It is a nine digit number (000-00-0000) followed by a letter or a letter and a number A, B, B2 C, C 1, D, E, F, or H. Your report cannot be processed without the correct claim number. LETTER YES 1. 2. CHANGE OF ADDRESS (Print new address at bottom) If the Social Security Administration is sending your payments to your financial organization, do you want this to continue? MONTH AND YEAR a. I am.

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