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  • Ssa-787 2018

Get Ssa-787 2018-2025

PLEASE COMPLETE THE INFORMATION ON THE REVERSE OF THIS FORM Form SSA-787 05-2010 ef 05-2010 Destroy Prior Editions 1. SOCIAL SECURITY ADMINISTRATION Form Approved OMB No* 0960-0024 TOE 250 PHYSICIAN S/MEDICAL OFFICER S STATEMENT OF PATIENT S CAPABILITY TO MANAGE BENEFITS Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U. In replying use this address S*C. 3507 as amended by Section 2 of the Paperwork Reduction Act of 1995. You do not need to SOCIAL SECURITY ADMINISTRATION answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 10 minutes to read the instructions gather the facts and SECURITY OFFICE* You can find your local Social Security office through SSA s website at www. socialsecurity. gov* Offices are also listed under U*S* Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 TTY 1-800-325-0778. Send only comments re....

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How to fill out the SSA-787 online

Filling out the SSA-787 form is a crucial method for assessing a person's capability to manage their Social Security benefits. This guide provides a clear and systematic approach to completing the form online, ensuring you have the necessary information at hand.

Follow the steps to complete the SSA-787 online accurately.

  1. Press the ‘Get Form’ button to download the SSA-787 form and open it in the available editor.
  2. Begin by filling in the identifying information section, including the patient’s name, Social Security number, date of birth, and address. Ensure all data is accurate and complete.
  3. Provide details regarding the medical source, including their name, address, title, and telephone number.
  4. Respond to questions regarding your relationship with the patient, starting with the date you first saw the patient and the date of the last visit.
  5. Indicate how many times you have seen the patient to assist in assessing their ability to manage funds.
  6. Assess the patient’s financial management abilities by answering the relevant questions about their understanding of finances, ability to handle a bank account, and timeliness in paying bills.
  7. Determine whether the patient can direct the management of their funds for basic needs such as food and shelter. Provide a summary of your findings to support your conclusion.
  8. Conclude by assessing the patient's potential to manage their benefits in the future and explaining your rationale.
  9. Finally, review the completed form for accuracy, sign it as the medical source, and include the date of signing.
  10. You can save the changes made to the form, download it for your records, print it, or share it as needed.

Start completing your documents online for a seamless management experience.

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Fill SSA-787

A representative payee is someone who manages the patient's SSA benefits to make sure the patient's basic needs are met. The patient shown above has filed for or is receiving Social Security or Supplemental Security income payments. Form SSA-787 (11-2002) EF (11-2002) Destroy Prior Editions. The medical source may mail or fax the completed SSA787, other form, or summary report, directly back to SSA.

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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