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  • How To Fill Out Statement Of Claimant Or Other Person

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Form Approved OMB No. 0960-0045 SOCIAL SECURITY ADMINISTRATION STATEMENT OF CLAIMANT OR OTHER PERSON NAME OF WAGE EARNER, SELF-EMPLOYED PERSON, OR SSI CLAIMANT SOCIAL SECURITY NUMBER NAME OF PERSON.

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How to use or fill out the How To Fill Out Statement Of Claimant Or Other Person online

Filling out the Statement of Claimant or Other Person is an important step in your application with the Social Security Administration. This guide will provide you with clear and concise instructions on how to complete the form online to ensure all information is accurately reported.

Follow the steps to fill out the form correctly.

  1. Press the ‘Get Form’ button to access the Statement of Claimant or Other Person form and open it in your preferred editing tool.
  2. Begin by entering the name of the wage earner, self-employed person, or SSI claimant in the designated field.
  3. Next, provide the Social Security number of the wage earner, self-employed person, or SSI claimant, ensuring accuracy to avoid delays.
  4. If you are someone other than the wage earner, self-employed person, or SSI claimant making the statement, enter your name in the specified field.
  5. Indicate your relationship to the wage earner, self-employed person, or SSI claimant in the corresponding section.
  6. In the space provided, read the certification statement and ensure to check any necessary boxes or provide any additional declarations required.
  7. Complete the signature section by signing your name, followed by the date of signing. Make sure to write clearly.
  8. Include your telephone number with the area code in the designated field.
  9. Fill out your mailing address, including the street address, city, state, and ZIP code.
  10. If the statement has been signed by mark (X), two witnesses must sign the form below, providing their addresses.
  11. Finally, review all entries for completeness and accuracy. Once satisfied, you can save changes, download the completed form, print it, or share it as needed.

Complete your documents online to ensure a smooth application process.

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SSA-795. Statement of Claimant or Other Persons. SSA-820-BK. Work Activity Report (Self-Employed Person)

A Form SSA 795 is known as a Statement of Claimant or Other Person. It will be received and recorded by the Social Security Administration in the United States. The form will be used by a third party to make a statement about the applicant's employment or wages.

If you have a personal my Social Security account, you can get an estimate of your future retirement benefits and see the effects of different retirement age scenarios. If you don't have a personal my Social Security account, create one at .ssa.gov/myaccount.

Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.

A Form SSA 795 is known as a Statement of Claimant or Other Person. It will be received and recorded by the Social Security Administration in the United States. The form will be used by a third party to make a statement about the applicant's employment or wages.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
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