FSM Social Security Administration P. O. Box L Kolonia Pohnpei FM 96941 Tel. No. 691 320-2708 Fax No. 691 320-2607 E-Mail fsmssa mail.fm FSMSS-118 Sept. Have you remarried yes no 3. Do you have children receiving social security benefits 4. Are any of the children receiving social security benefits married working adopted no longer live with you yes no name of child ss number died Wage Earner s Name IMPORTANT n This survey form must be notarized if not signed in the presence of a representative of the FSMSSA. n If you are living abroad and employed please submit along with this survey form copies of W-2 forms for all years you have been employed. BENEFICIARY S DECLARATION I understand that any false statement or misrepresentation of any fact in maintaining a right for benefits is a crime punishable under Title 53 of the FSM Code. 2012 QUESTIONNAIRE Dear Beneficiary Please complete this survey and submit it to our office as soon as possible. Failure to do so will result in benefit withh....
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How to fill out the SSA FSMSS-118 online
Filling out the SSA FSMSS-118 form accurately is crucial for maintaining your benefits. This guide will help you navigate the process of completing the form online with clear steps and helpful tips.
Follow the steps to successfully complete the SSA FSMSS-118 form.
- Press the ‘Get Form’ button to acquire the SSA FSMSS-118 form and open it using your chosen form editor.
- Begin by providing your status as a beneficiary by selecting whether you are a retiree, disability recipient, or surviving spouse. Indicate if you are currently working and, if so, provide the start date of your employment.
- Answer the question regarding whether your condition has improved by selecting 'yes' or 'no'. This section is mandatory for all users, so be sure not to leave it blank.
- If applicable, answer the question regarding the death of a retiree or disability recipient. Provide the name and Social Security number of the deceased individual and the date of their passing.
- For surviving spouses or guardians, indicate if you are currently working, and if yes, provide the date when you started working.
- Answer whether you have remarried and whether you have children receiving social security benefits. Provide details on any such children, including their names and Social Security numbers. Answer additional questions regarding their marital status, employment status, adoption status, and residency.
- Complete the Beneficiary’s Declaration section, ensuring that you understand the legal implications of providing false information.
- Fill in your printed name, signature, and date. If an authorized representative is signing on your behalf, they must also complete their section and attach the necessary authorization slip.
- Provide your current address and contact information, including your telephone and cell phone numbers.
- Review all entered information for accuracy before saving your changes. Once completed, you may download, print, or share the form as needed.
Complete your SSA FSMSS-118 form online today to ensure your benefits continue without interruption.
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