He Census and to private entities under contract with us). A complete list of when we may share your information with others, called routine uses, is available in our Privacy Act System of Records Notices 60-0089, entitled, Claims Folders Systems; and, 60-0090, entitled, Master Beneficiary Record. Additional information about these and other system of records notices and our programs are available online at www.socialsecurity.gov or at your local Social Security office. We may share the informat.

How it works
  • Open form

    Open form follow the instructions

  • Easily sign form

    Easily sign the form with your finger

  • Share form

    Send filled & signed form or save

How to fill out the SSA-3369-BK online

The SSA-3369-BK, also known as the Work History Report, is a crucial form used to gather information about your work history as part of your disability claim. This guide provides clear steps on how to fill out this form online, ensuring you provide the necessary details accurately.

Follow the steps to fill out the SSA-3369-BK online effectively.

  1. Press the ‘Get Form’ button to obtain the form and open it in the online editor.
  2. Begin by entering your name, social security number, and daytime telephone number in Section 1.
  3. Proceed to Section 2. List all jobs you have held in the past 15 years before your disabilities began. Include the job title, type of business, and dates worked.
  4. For each job listed, you'll need to provide additional details. In the job description section, clearly describe your daily tasks.
  5. Indicate whether you used machines, tools, or technical knowledge during the job, and how many hours you spent on various tasks each day.
  6. Specify the lifting and carrying requirements of each job, including what you lifted and how often this occurred.
  7. Complete the supervisory questions if you managed others during your employment, including details about your role.
  8. Continue through the form for each job, repeating steps 4 through 7 as needed for all jobs listed.
  9. Use the Remarks section on Page 8 to provide any additional information or explanations as necessary.
  10. Finally, ensure you fill in your contact information, including your name and address if another person is completing the form for you.
  11. Once completed, you can save changes, download, print, or share the form as required.

Complete your SSA-3369-BK form online today to help streamline your disability claim process.

Get form

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

Related content

Work History Report - Social Security

WORK HISTORY REPORT- Form SSA-3369-BK. READ ALL OF THIS INFORMATION BEFORE. YOU BEGIN...

Learn more
[MOBI] Ssa 3373 Bk Fillable

Jul 13, 2020 - 3373 Eventually, you will … Work History Report - SSDFacts.com. Work...

Learn more
Auction - Bentley & Associates, LLC

BK PRECISION 1601 REGULATED DC POWER. SUPPLY ... SSI OHM-STAT RT-1000 ENVIROMENT &...

Learn more
Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

If you believe that this page should be taken down, please follow our DMCA take down process here.

Get SSA-3369-BK