We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Ssa 795

Get Ssa 795

Certify that -. Form SSA-795 (8-2002) EF (12-2002) Destroy Prior Editions ... the Paperwork Reduction Act of 1995. You do not need to answer these questions .

This website is not affiliated with any governmental entity

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Ssa 795 online

The Ssa 795 form, also known as the Statement of Claimant or Other Person, is essential for providing information to the Social Security Administration. This guide will help you navigate the online completion of this form with clear and supportive instructions.

Follow the steps to fill out the Ssa 795 form online

  1. Use the ‘Get Form’ button to access the Ssa 795 form and open it in your selected editing tool.
  2. In the first section, provide the name of the wage earner, self-employed person, or SSI claimant. This is critical for identifying the individual relevant to the information being provided.
  3. If you are not the wage earner, self-employed person, or SSI claimant, fill in your name in the appropriate field. Ensure that this information is accurate to avoid any miscommunication.
  4. Next, enter the social security number of the wage earner, self-employed person, or SSI claimant. This step is vital for proper processing by the Social Security Administration.
  5. Indicate your relationship to the individual named in the previous fields. Be precise to ensure that the nature of your association is clearly understood.
  6. Read and understand the certification statement. By signing, you declare that the information provided is true and correct to the best of your knowledge.
  7. Add your signature in the designated area. This should include your first name, middle initial (if applicable), and last name, written in ink.
  8. Date your signature by filling in the date in the prescribed format (month, day, year). This is important for documentation purposes.
  9. Provide your telephone number with the area code for any possible follow-up questions from Social Security representatives.
  10. Complete the mailing address section with your current address. This should include the street number and name, apartment number (if applicable), city, state, and ZIP code.
  11. If you signed the form with a mark (X), ensure that two witnesses sign below, providing their full addresses. Note that witnesses are not required if the signature is not a mark.
  12. Once you have completed all sections, review your entries for accuracy. Save your changes and then proceed to download, print, or share your completed form as needed.

Get started on filling out your Ssa 795 form online today!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

SSA-795 - Social Security
... that this statement is for the use of the Social Security Administration, I hereby...
Learn more
Mother's SSN A. POLICY - NIWAP Library
(Destroy the SSA-795 if a decision is subsequently made to process the SS-5.) • If the...
Learn more
generator - Absolute Water Pumps
(650 X 1,140 X 795 mm). Dry Net Weight. 526 lbs. (239 kg). NOTICE. In keeping with...
Learn more

Related links form

201-morgan-11-4003 - Kentucky Transportation Cabinet 102-henry-12-1316 - Kentucky Transportation Cabinet Court Referral Insurance Form 6-01-2012.doc 323-butler-12-2364 - Kentucky Transportation Cabinet

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

A representative payee is someone who manages the patient's money to make sure the patient's needs are met. The payee has a strong and continuing interest in the patient's well-being and is usually a family member or close friend. incapable of managing his/her own money.

General information for recording statements on the SSA-795. Use an SSA-795 whenever a signed statement is required or desirable, except when we request some other form or questionnaire or we can readily adapt for the statement.

The SSA-787, Medical Source Opinion of Patient's Capability to Manage Benefits, is the preferred vehicle for obtaining medical evidence of capability.

SSA uses the information from Form SSA-788 to verify payee applicants' statements of concern and to identify other potential payees. SSA is concerned with selecting the most qualified representative payee who will use Social Security benefits in the beneficiary's best interest.

Where do I send form SSA-795? The office is 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 Boulevard, Baltimore, MD 21235-6401.

(b) Examples of circumstances where good cause may exist include, but are not limited to, the following situations: (1) You were seriously ill and were prevented from contacting us in person, in writing, or through a friend, relative, or other person. (2) There was a death or serious illness in your immediate family.

General information for recording statements on the SSA-795. Use an SSA-795 whenever a signed statement is required or desirable, except when we request some other form or questionnaire or we can readily adapt for the statement.

SSA and its affiliated State disability determination services use Form SSA-827, "Authorization to Disclose Information to the Social Security Administration (SSA)" to obtain medical and other information needed to determine whether or not a claimant is disabled.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Ssa 795
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232