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Form SSA-89 02-2018 Discontinue Previous Editions Social Security Administration Page 1 of 2 OMB No.0960-0760 Authorization for the Social Security Administration SSA To Release Social Security Number SSN Verification Printed Name Date of Birth I want this information released because I am conducting the following business transaction Reason s for using CBSV Please select all that apply Mortgage Service Banking Service Background Check License Requirement Credit Check Other 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. The name and address of the Company s Agent is I am the individual to whom the Social Security number was issued or the parent or legal guardian of a minor or the legal guardian of a legally incompetent adult. I declare and affirm under the penalty of perjury that the information contained her....

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How to fill out the SSA-89 online

The SSA-89 form is an authorization request for the Social Security Administration to release Social Security number (SSN) verification to a designated company. Filling out this form online is a straightforward process, and this guide will provide you with step-by-step instructions to ensure you complete it correctly.

Follow the steps to complete the SSA-89 form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Enter your printed name in the designated field. This should be your full legal name as documented.
  3. Fill in your date of birth. This should be in the format of month, day, and year.
  4. Provide your Social Security number in the appropriate field.
  5. Select one reason for authorizing consent from the options provided, such as applying for a mortgage or loan.
  6. In the ‘Company Name’ field, type the name of the company you are authorizing to access your SSN verification.
  7. Fill in the ‘Company Address’ field with the full address of the company.
  8. If applicable, enter the name and address of the company's agent in the corresponding fields.
  9. Authorize the Social Security Administration by affirming your identity. Indicate if you are the individual whose SSN was issued or if you are acting as a guardian.
  10. Sign the form in the provided signature area. You may also need to initial the designated area.
  11. Enter the date you signed the form.
  12. If you are not the individual to whom the SSN was issued, provide your relationship to the person named.
  13. Review your information for accuracy. Ensure all fields are completed as required.
  14. Once you are satisfied with the form, proceed to save the changes, and you can choose to download it, print it, or share it as needed.

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