Get Ssa 4290 F

The Ssa 4290 F is a crucial document for individuals engaged in vocational rehabilitation or similar programs. This guide will provide you with a step-by-step overview of how to efficiently complete this form online.

Follow the steps to fill out the Ssa 4290 F online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the beneficiary's name in the designated field, ensuring you provide the last name, first name, and middle initial accurately.
3. Fill in the beneficiary's date of birth in the specified format to ensure it is correctly recorded.
4. Indicate the type of claim by selecting the appropriate checkbox among the options provided: '01', '551', or 'Concurrent'.
5. Input the beneficiary's Social Security number in the corresponding field.
6. If applicable, enter the wage earner's Social Security number, ensuring it differs from the beneficiary's if necessary.
7. Complete the address section with the beneficiary's full address, including the number and street, city, state, and zip code.
8. Select the type of vocational rehabilitation services the beneficiary is receiving by checking the appropriate box for either an Employment Network, State Vocational Rehabilitation agency, other provider, or educational institution.
9. Provide the name, address, and telephone number of a contact person from the identified organization or agency.
10. In the DDS/FO Information section, the person completing Part I should sign, enter their title, and date the document.
11. Fill in the DDS or Field Office code and include a telephone number with the area code.
12. Once all sections are complete, review the form for accuracy. Save your changes, and download, print, or share the completed form as necessary.

Start filling out your Ssa 4290 F online today.