Get Ssa Ha-85 2014-2025

The SSA HA-85 form allows individuals to request the withdrawal of a previously filed hearing request. This guide provides step-by-step instructions to help users navigate the online process with ease and ensure all necessary information is accurately submitted.

Follow the steps to successfully complete the SSA HA-85 form online.

1. Click ‘Get Form’ button to obtain the form and open it in your designated editor.
2. Fill in your name in the ‘Claimant Name’ section, ensuring accuracy as this will identify you in the SSA records.
3. Enter your Social Security Number (SSN) in the provided field to associate your request with your personal records.
4. If applicable, provide the wage earner’s name or the name of a surviving spouse in the corresponding section.
5. If you have a different claim number, include it in the appropriate field to facilitate the processing of your request.
6. Indicate the date of your original hearing request to provide context for your withdrawal.
7. Specify the benefit you are applying for and indicate the type of claims you are withdrawing.
8. Affirm your desire to withdraw your hearing request by selecting the checkbox that confirms your request is voluntary and that you understand the potential consequences.
9. Provide a reason for your withdrawal in the designated area. If more space is needed, utilize the reverse side of the form.
10. Sign the form if you opt to do so, providing your name and the date. If signed by marking, include two witnesses’ signatures and addresses.
11. Finally, save your changes, then download, print, or share the completed form as necessary to finalize the submission process.

Complete the SSA HA-85 form online today for a seamless withdrawal process.