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Get SSA-820-BK 2012

R Or Receiving Benefits Please answer each of the questions on this form with as many details as you can. This information will help us decide if you should get or keep getting disability benefits. If you need more room for your answers, go to the Remarks section at the end of the form. 1. Have you had any self-employment income since the DATE shown above in the Identification section? (check one) NO. If you did not work but income was reported for you, go to Question 2. YES. Go to Question 3. .

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