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  • US Legal Forms
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  • Ssa-795 2009

Get Ssa-795 2009

Read the instructions, gather the facts, and answer the questions. SEND THE COMPLETED FORM TO YOUR LOCAL SOCIAL SECURITY OFFICE. The office is listed under U. S. Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You may send comments on our time estimate above to: SSA, 6401 Security Boulevard, Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address, not the completed form. I declare under pen.

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How to fill out the SSA-795 online

Filling out the SSA-795 form online is a straightforward process designed to assist individuals in submitting important information to the Social Security Administration. This guide provides clear instructions to help users complete the form accurately and with confidence.

Follow the steps to fill out the SSA-795 form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the name of the wage earner, self-employed person, or SSI claimant. This is a crucial first step as it identifies the primary individual related to the statement.
  3. Next, input the Social Security number of the wage earner or claimant. Ensure that this information is accurate to avoid processing delays.
  4. If the person making the statement is different from the wage earner or claimant, provide their name in the designated field. If applicable, fill out their relationship to the wage earner or claimant.
  5. Carefully read the privacy act statement. This informs you how the information will be used and ensures your understanding of the voluntary nature of the submission.
  6. Signature is required from the person making the statement. Ensure that you write your first name, middle initial, and last name clearly in ink.
  7. Enter the date of signing in the specified format (month, day, year).
  8. Provide a telephone number, including area code, for potential follow-ups or inquiries regarding the submitted form.
  9. Fill in the mailing address, including number and street, apartment number (if applicable), city, state, and ZIP code. This is your contact information.
  10. If the statement has been signed by mark (X), two witnesses must sign below, including their addresses.
  11. Once all sections are completed, review the form for accuracy and completeness. After ensuring everything is correct, save changes, and choose to download, print, or share the form as needed.

Complete your SSA-795 form online today for efficient and accurate processing.

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Form SSA-3368 is the basic form used for adults who are claiming disability benefits. ... The SSA has other forms which they will ask your doctor to fill out on your behalf. You should include copies of all of your pertinent medical records when you turn this form in. Much of Form SSA-3368 is simple and straightforward.

SSI stands for Supplemental Security Income. Social Security administers this program. We pay monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. Blind or disabled children may also get SSI.

We base Social Security benefits on your lifetime earnings. We adjust or index your actual earnings to account for changes in average wages since the year the earnings were received. Then, Social Security calculates your average indexed monthly earnings during the 35 years in which you earned the most.

Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.

A Form SSA 795 is known as a Statement of Claimant or Other Person. It will be received and recorded by the Social Security Administration in the United States. The form will be used by a third party to make a statement about the applicant's employment or wages.

The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.

Social Security benefits provide partial replacement income for qualified retirees and disabled individuals, as well as for their spouses, children, and survivors. An individual must pay into the Social Security program during their working years and accrue 40 credits in order to qualify for benefits.

A BPQY statement contains detailed information about the status of a beneficiary's disability cash benefits, scheduled medical reviews, health insurance, and work history. In essence, the BPQY provides a snapshot of the beneficiary's benefits and work history as stored in SSA's electronic records.

Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.

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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
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-795
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