We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Independent Agency Forms
  • Independent Agency SSA Forms
  • Ssa-3369-bk 2003

Get Ssa-3369-bk 2003

the information you give us when we match records by computer. Matching programs compare our records with those of other Federal, State, or local government agencies. Many agencies may use matching programs to find or prove that a person qualifies for benefits paid by the Federal government. The law allows us to do this even if you do not agree to it. Explanations about these and other reasons why information you provide us may be used or given out are available in Social Security offices. Pape.

This website is not affiliated with any governmental entity

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the SSA-3369-BK online

The SSA-3369-BK, also known as the Work History Report, is a crucial document for individuals applying for disability benefits. This guide provides step-by-step instructions on how to complete the form online effectively.

Follow the steps to successfully complete the SSA-3369-BK online.

  1. Press ‘Get Form’ button to acquire the SSA-3369-BK and access it in the online editor.
  2. Begin by filling out Section 1, which requires information about the person applying for disability benefits. Enter the applicant's name, Social Security number, and a reachable daytime telephone number.
  3. Move to Section 2, where you will list all the jobs held in the last 15 years before the person was unable to work. Fill in each job title, type of business, and the dates worked.
  4. For each job listed, there are additional fields to detail the specific duties performed, including hours worked per day, rate of pay, and various physical activities involved in the job such as walking, standing, and lifting.
  5. Complete all relevant sections, ensuring nothing is left blank. Use the 'REMARKS' section on Page 8 if additional space is needed to elaborate on answers or provide further context.
  6. Finally, ensure that the bottom of Page 8 is completed, providing the name and address of the individual who filled out the form, along with the date.
  7. Once all sections are completed, you can save your changes, download the form, or print it out for submission.

Start completing your SSA-3369-BK form online today to ensure a smooth application process.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

Work History Report - Social Security
WORK HISTORY REPORT- Form SSA-3369-BK. READ ALL OF THIS INFORMATION BEFORE. YOU BEGIN...
Learn more
[MOBI] Ssa 3373 Bk Fillable
Jul 13, 2020 - 3373 Eventually, you will … Work History Report - SSDFacts.com. Work...
Learn more
Auction - Bentley & Associates, LLC
BK PRECISION 1601 REGULATED DC POWER. SUPPLY ... SSI OHM-STAT RT-1000 ENVIROMENT &...
Learn more

Related links form

CT B-148 2016 CT B-200 2001 CT B-203 2016 CT B-214 1983

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

After a Conference which lasted throughout July, the bill was finally passed and sent to President Roosevelt for his signature. The Social Security Act was signed into law by President Roosevelt on August 14, 1935.

Name and address. Social security claim number. Name of child beneficiary to whom this statement applies. Date child attains age 18. Current school attendance. ... Last school year. ... Signature of student. ... Certification by School Official.

What Is Form SSA-3373-BK? ... If those medical records don't provide enough information to make a decision, then the SSA will typically ask you to fill out Form SSA-3373-BK.

Check With Your State Tax Department or Unemployment Office. ... Request Employment History from Social Security. ... Use Your Tax Returns. ... Request Transcripts of Your Tax Returns. ... Check With Prior Employers.

0:29 7:51 Suggested clip How to Fill Out the Work History Report Form | Cleveland, Ohio ...YouTubeStart of suggested clipEnd of suggested clip How to Fill Out the Work History Report Form | Cleveland, Ohio ...

Accessing past tax records, W2 or 1099 forms, or paystubs. Submitting a Request for Social Security Earnings Information Form (requires fee) with the Social Security Administration. Contacting previous employers' human resources departments.

The Adult Function Report It is also sent during Continuing Disability Reviews for people already approved. Social Security uses this form to learn a little more about how your illness limits you and to see if what you write about your limitations is similar to what your doctor writes.

If you're 18 years old or older, you can create a my Social Security account. At www.socialsecurity.gov/ myaccount, you can get your Social Security Statement to check your earnings record, and see estimates of future retirement, disability, and survivor benefits.

Social Security records All of your employment history should be tied to that number. Social Security records will also report the percentage of income you paid to the Social Security benefits program. Visit the Social Security Administration's website and search for Form 7050.

The most basic fact of the SSA disability process is simply that most cases will be denied, often because there wasn't enough medical evidence to prove the case, forcing claimants to go through the disability appeal process. Disability claimants should never resign themselves to giving up on an SSDI or SSI claim.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get SSA-3369-BK
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
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-3369-BK
This form is available in several versions.
Select the version you need from the drop-down list below.
2014 SSA-3369-BK
Select form
  • 2014 SSA-3369-BK
  • 2011 SSA-3369-BK
  • 2009 SSA-3369-BK
  • 2008 SSA-3369-BK
  • 2005 SSA-3369-BK
  • 2003 SSA-3369-BK
Select form