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Get SSA-89 2007

On Printed Name: Date of Birth: Social Security Number: I am conducting the following business transaction: [Identify a specific purpose. Example-seeking a mortgage from the Company- "identity verification" or "identity proof or confirmation" is not acceptable.] with the following company ("the Company"): Company Name: Company Address: I authorize the Social Security Administration to verify my name and SSN to the Company and/or the Company's Agent, if applicable, for the purpose I identified.

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