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  • Ssa-3368-bk 2015

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Ntary. However, failing to provide us with all or part of the information could prevent us from making an accurate and timely decision on the named claimant’s claim. We rarely use the information you supply for any purpose other than to make decisions regarding claims. We may also disclose information to another person or to another agency in accordance with approved routine uses, which include but are not limited to the following: 1. To enable a third party or an agency to assist Social Secur.

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How to fill out the SSA-3368-BK online

Filling out the SSA-3368-BK online is an important step in your disability claim process. This guide provides detailed, step-by-step instructions to help you navigate the form accurately and efficiently.

Follow the steps to complete the SSA-3368-BK form online.

  1. Press the ‘Get Form’ button to access the SSA-3368-BK form and open it in your preferred online editor.
  2. Begin by providing your personal information in Section 1, including your full name, Social Security number, mailing address, email, and phone numbers.
  3. In Section 2, list a contact person who can provide information about your medical conditions, along with their relationship to you and contact details.
  4. Section 3 requires you to list all physical or mental conditions that limit your ability to work. Be thorough and specific.
  5. In Section 4, address your work activity, including whether you are currently working or have stopped working, and provide relevant dates.
  6. Continue to Section 5 to fill out your educational background, indicating the highest grade completed and any specialized training.
  7. Section 6 asks for a history of your work experience over the past 15 years. List jobs chronologically and provide details about job duties.
  8. Next, in Section 7, indicate any medications you are currently taking, including prescription and non-prescription drugs.
  9. In Section 8, document your medical treatment history, listing healthcare providers and places where you have received care.
  10. Section 9 allows you to provide additional medical information if there are other sources of relevant information about your health.
  11. If applicable, complete Section 10 regarding any vocational rehabilitation or employment support services you are involved with.
  12. Utilize Section 11 for any remarks or additional information that didn't fit into previous sections.
  13. Review the entire form for completeness and accuracy before saving your changes, downloading, printing, or sharing the form.

Complete your SSA-3368-BK form online today to ensure your disability application is processed quickly.

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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
SSA-3368-BK
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  • DISABILITY REPORT - ADULT PLEASE READ THIS INFORMATION BEFORE ...
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