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Get SSA-795 2015

ERSON MAKING STATEMENT (If other than above wage earner, self-employed person, or SSI claimant) RELATIONSHIP TO WAGE EARNER, SELFEMPLOYED PERSON, OR SSI CLAIMANT Understanding that this statement is for the use of the Social Security Administration, I hereby certify that - Form SSA-795 (03-2015) ef (03-2015) Destroy Prior Editions Privacy Act Statement Collection and Use of Personal Information Section 205a of the Social Security Act (42 U.S.C. § 405a), as amended, authorizes us to collect.

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