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
  • More Forms
  • More Multi-State Forms
  • Free Function Report Adult Third Party Form Ssa-3380-bk

Get Free Function Report Adult Third Party Form Ssa-3380-bk

FORMATION BEFORE YOU BEGIN COMPLETING THIS FORM IF YOU NEED HELP HOW TO COMPLETE THIS FORM The information that you give on this form will be used to make a decision on the disabled person's claim. You can help by completing as much of the form as you can. When a question refers to the "disabled person," it refers to the person who is applying for or receiving disability benefits. It is important that you tell us what you know about the disabled person's activities and abilities. DO NOT ASK THE.

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 Free Function Report Adult Third Party Form SSA-3380-BK online

Filling out the Free Function Report Adult Third Party Form SSA-3380-BK is an essential step in assisting with disability claims. This guide provides a clear, step-by-step approach to completing the form online, ensuring you provide the necessary information accurately and efficiently.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to access the form and open it in the editing interface.
  2. Begin by entering the name of the disabled person in the designated field at the top of the form. Make sure to include their first, middle, and last names.
  3. Next, provide your own name as the person completing the form. This will help identify your relationship to the disabled person.
  4. Indicate your relationship to the disabled person by selecting from the options provided. This information is crucial for understanding your perspective.
  5. Input the date you are completing the form in the specified format (MM/DD/YYYY). Be careful to ensure that the date is correct.
  6. Fill in your daytime telephone number. If you do not have a number, provide an alternate contact number where you can receive messages.
  7. Detail how long you have known the disabled person and describe the typical activities you engage in together. This provides context about your relationship.
  8. Select the living situation of the disabled person by checking the appropriate box, such as 'house' or 'apartment'. Additionally, indicate who they live with.
  9. Proceed to Section B, where you will describe any relevant illnesses, injuries, or conditions and how they affect the disabled person's ability to work.
  10. Continue filling out Section C, which focuses on daily activities. Provide details on what the disabled person does in a typical day and any personal care tasks they may struggle with.
  11. Complete Section D by checking any items that indicate how the disabled person's conditions affect their abilities, such as lifting or walking, and provide explanations for each.
  12. Use the 'REMARKS' section on Page 10 if additional space is needed to elaborate on any answers, ensuring all aspects are covered completely.
  13. Finally, ensure you provide your name, address, and optional email address at the bottom of the page before submitting the form.
  14. Once finished, save your changes, download, print, or share the completed form as needed.

Complete your forms online today to ensure accurate and timely assistance with disability claims.

Get form

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

Related content

ADULT - THIRD PARTY Form SSA-3380-BK
For SSA Use Only. Do not write in this box. How the disabled person's illnesses, injuries...
Learn more
Appendix C: Selected Forms | Informing Social...
... (Form SSA-11-BK), 176. Adult Function Report Form (Form SSA-3373-BK), 186. Adult Third...
Learn more
Social Security Forms | SSA
Forms ; SSA-3380-BK, Function Report - Adult - Third Party Form ; SSA-3441-BK, Disability...
Learn more

Related links form

Form 571 L San Francisco Pdf Consent For Release Of Medical Information - Khoo Teck Puat Hospital Unfair Dismissal Application Form Msds Mary Kay Timewise Form

Questions & Answers

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

Contact support

Our website is the best way for most people to get help. our website, call our National 800 Number (1-800-772-1213) or your local Social Security office for help. We will schedule an appointment to serve you by phone or in person.

The Function Report is a 10-page form that asks about your daily activities and how your health conditions affect your ability to work or go through life. It's also one of the main forms you'll fill out when you apply for Social Security disability benefits. It's also one of the most important forms in the application.

SSD Function Report FAQs. Function Report Question # 7: Do you take care of anyone else such as a wife/husband, children, grandchildren, parents, friend, other? Be very specific here; if you provide care for someone else, don't assume the reader understands what that means.

The Function Report (SSA-3373) helps DDS to obtain information about how an applicant's illness(es) and condition(s) affect their ability to function and perform everyday tasks.

You can apply: Online; or. By calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or visiting your local Social Security office. Call ahead to make an appointment. If you do not live in the U.S. or one of its territories, you can also contact your nearest U.S.

Visit .ssa.gov/myaccount to get started. You will have the option to create an account with one of our credential service providers, Login.gov or ID.me. Keep in mind: You must be 18 years of age or older and have a Social Security number (SSN).

The Function Report - Adult - Third Party Form SSA-3380-BK is a document used by the Social Security Administration for individuals to report the functional capabilities of a disabled person.

If you would like to receive your Social Security Statement by mail, please print and complete a "Request For Social Security Statement" (Form SSA-7004) and mail it to the address provided on the form. You should receive your paper Social Security Statement in the mail in four to six weeks.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
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 Free Function Report Adult Third Party Form SSA-3380-BK
Get form
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
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