Use remarks if you need more space. Form SSA-11-BK 01-2014 EF 01-2014 Use 08-2009 EF 08-2009 edition until exhausted Page 1 NO 6. We estimate that it will take about 11 minutes to read the instructions gather the facts and answer the questions. Send only comments relating to our time estimate above to SSA 6401 Security Blvd Baltimore MD 21235-0001. 16. a Have you ever been convicted of a felony If YES What was the crime On what date were you convicted What was your sentence If imprisoned when were you released If probation was ordered when did/will your probation end b Have you ever been convicted of any offense under federal or state law which resulted in imprisonment for more than one year Page 3 17. Do you have any unsatisfied FELONY warrants or in jurisdictions that do not define crimes as felonies a crime punishable by death or imprisonment exceeding 1 year for your arrest If YES Date of Warrant State where warrant was issued REMARKS This space may be used for explaining any answe....
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How to fill out the SSA-11-BK form online
The SSA-11-BK form is a vital document for those seeking to be designated as a representative payee for another individual. This guide provides clear and comprehensive instructions on how to accurately complete the form online, ensuring ease of understanding for all users.
Follow the steps to successfully complete the SSA-11-BK online.
- Click the ‘Get Form’ button to access the SSA-11-BK form and open it in your device's editor.
- Begin filling out the form by providing the name of the number holder, the name of the claimant(s) you are applying for, and their Social Security number. Ensure these details are accurate and clearly printed.
- Indicate whether you request benefits to be paid directly to you as the claimant by checking the appropriate box and answering items 3, 5, 6, and 8.
- Provide a thorough explanation in item 2, describing why the claimant cannot handle their own benefits. Use this space to detail their current financial management.
- In item 3, explain why you would be the best representative payee, using additional remark space if necessary.
- Item 4 requires you to describe how you stay informed about the claimant's needs. Select from the provided options and provide additional details as needed.
- Complete items regarding the living arrangements of the claimant in item 6, indicating if they live alone, with relatives, or in an institution, and provide necessary additional information.
- In item 7, confirm the status of the claimant's parental relationships, ensuring to provide contact information for any living natural or adoptive parent.
- For item 8, list relatives or friends who offer support to the claimant, providing details about the nature of this support.
- Conclude the form by answering the relationship questions in item 9, and follow up with any relevant information in items 10 through 19. Once completed, save your entries.
- After reviewing the filled form for accuracy, download a copy, print it for your records, or share it as necessary.
Take the next step in managing benefits by filling out the SSA-11-BK online today.
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