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  • Ssa-1020b-ocr-sm-inst 2009

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, Sr., etc.) — — — APPLICANT’S SOCIAL SECURITY NUMBER APPLICANT’S DATE OF BIRTH (MM-DD-YYYY) 2. If you are married and living with your spouse, please provide the following information as it appears on your spouse’s Social Security card. If you are not currently married, do not live with your spouse or are widowed, skip to question 3 and do not include any information about your spouse on this application. FIRST NAME MI SUFFIX (Jr., Sr., etc.) LAST NAME — — SPOUSE’S SOC.

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How to fill out the SSA-1020B-OCR-SM-INST online

The SSA-1020B-OCR-SM-INST form is essential for applying for Extra Help with Medicare Prescription Drug Plan costs. This guide provides a straightforward, step-by-step approach to ensure users can confidently complete the form online.

Follow the steps to fill out the SSA-1020B-OCR-SM-INST effectively.

  1. Click the ‘Get Form’ button to access the SSA-1020B-OCR-SM-INST, allowing you to open and review the form in the online editor.
  2. Begin filling out Section 1 with the applicant's name as it appears on the Social Security card. Ensure you use capital letters and keep your entries within the designated boxes.
  3. If applicable, provide your spouse's name and Social Security number in Section 2. If you are not currently married, proceed to question 3.
  4. In question 3, indicate whether the value of your combined savings and investments exceeds the given limits, noting exceptions for certain properties.
  5. Continue to answer questions regarding your assets, income, and any support you provide to relatives living with you in sections 4 through 8.
  6. For questions 9 to 14, provide information about your employment and any relevant income details, ensuring accuracy for the figures reported.
  7. Review question 15 regarding your interest in Medicare Savings Programs. If you wish to be considered for this program, do not complete this question.
  8. Regardless of assistance, fill out Section A to provide your date and signature along with any necessary details about your mailing address.
  9. If someone assisted you in completing the form, ensure to fill in Section B, providing their details as necessary.
  10. After reviewing all your answers for accuracy, save your changes, and then proceed to download, print, or share the form as required.

Complete the SSA-1020B-OCR-SM-INST online today to apply for Extra Help with your Medicare expenses.

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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
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-1020B-OCR-SM-INST
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