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  • Mailing Address Ssa521 Form

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U.S. SSA Form ssa-ssa-521 SOCIAL SECURITY ADMINISTRATION TOE 420 REQUEST FOR WITHDRAWAL OF APPLICATION Form Approved OMB No. 0960-0015 Do not write in this space IMPORTANT NOTICE This is a request to cancel your application. If it is approved the decision we made on your application will have no legal effect all rights attached to an application including the rights of reconsideration hearing and appeal will be forfeited and any payments we made.

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Amended Related content

Form SSA-521 - Social Security
HERE. Date (Month, day, year). Telephone Number (include area code). Mailing Address...
Learn more
SSA-521 - SSDFacts
Mailing Address (Number and Street, Apt. No., P.O. Box, or Rural Route). ZIP Code ... Form...
Learn more
Form SSA-521 - Social Security
HERE. Date (Month, day, year). Telephone Number (include area code). Mailing Address...
Learn more

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To complete a SSA-521, you need to complete the following items: Name. Social security number. Type of benefit you wish to withdraw. Date of application. Whether you want to keep Medicare benefits. Reason for withdrawal. Signature of person making the request. Date.

You must present original documents or copies certified by the agency that issued them. We cannot accept photocopies or notarized copies. All documents must be current (not expired). We cannot accept a receipt showing you applied for the document.

Please include your Social Security number or claim number whenever you write to us. 6401 Security Blvd. Please do not send applications or documents needed to request a Social Security number or benefits to this address.

If you get Social Security benefits (retirement, survivors, or disability) or are enrolled in Medicare, you can change your address or direct deposit information online using the My Profile tab in your personal my Social Security account. You can also decide when the change will take effect.

Yes, faxing is secure under all appropriate privacy rules. Can I fax evidence using my PC fax software? Yes. However, the first page for each document you are sending must be the barcode provided to you by the Social Security office or State Disability Determination Services (DDS) that is handling the disability claim.

You can upload documents by using the Send Response for Individual Case link on the Electronic Records Express Home page. The upload function is also available while accessing a claimant's electronic folder through the Access Claimant's Electronic Folder link.

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.

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© 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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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