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  • Form Approved Omb No 0960-0045 Social Security

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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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Related content

Statement of Claimant or Other Person - Social...
Social Security Administration. OMB No. 0960-0045. Form SSA-795 (02-2020) UF. Discontinue...
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Federal Forms OMB NumberTitle0960-0729Authorization for SSA to Obtain Account Records From a Financial Institution and Request for Records (Medicare Part D Subsidy)0960-0728Request for Review By A Federal Reviewing Official, 20 CFR 405.1, .120, .210, .215, .220, .225, .230243 more rows

OMB 0960-0101 SSA collects the information when a surviving widow(er) is not already entitled to a monthly benefit on the same earnings records, or is not filing for a lump-sum death payment as a former spouse.

OMB 0960-0623 Therefore, the applicant must authorize release of information from various sources to SSA. The applicants use Form SSA 827, or the Internet counterpart, i827, to provide consent for the release of medical records, education records, and other information related to their ability to perform tasks.

The OMB control number is OMB 0960-0818. We estimate that it will take about 5 minutes to read the instructions, gather the facts, and answer the questions.

A Consent for Release of Information (SSA-3288) must be signed by each individual whose work history will be used to establish the 40 quarters of coverage information. However, a consent form is not needed when requesting information on a deceased individual's Social Security Number.

You can provide this authorization by signing a form SSA-827. Federal law permits sources with information about you to release that information if you sign a single authorization to release all your information from all your possible sources. We will make copies of it for each source.

Form SSA- 827 (.pdf) SSA and its affiliated State disability determination services use Form SSA-827, "Authorization to Disclose Information to the Social Security Administration (SSA)" to obtain medical and other information needed to determine whether or not a claimant is disabled.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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