Affidavit by Parent to Prove Date of Birth of Child and Parentage to Social Security Administration in Order to Receive Benefits
About this form
This form is an Affidavit by Parent to Prove Date of Birth of Child and Parentage to the Social Security Administration. It is designed to establish a child's date of birth and the relationship between the parent and the child for purposes of qualifying for Social Security benefits. This affidavit differs from a birth certificate as it serves as a sworn statement from a parent, which may be needed when a birth certificate is unavailable or cannot be provided.
Main sections of this form
- Name of the parent making the affidavit.
- Name of the minor child.
- Date of birth of the child.
- Name and address of the hospital or clinic where the child was born.
- Purpose of the affidavit as it relates to an application for benefits.
- Signature of the parent and notarization details.
When this form is needed
This form should be used when a parent must provide proof of their child's date of birth and parentage to the Social Security Administration (SSA) for benefit eligibility. Scenarios where this might arise include applying for child disability benefits or claiming spousal benefits where age verification is necessary.
Who this form is for
This form is suitable for:
- Parents of minor children who need to establish age and parentage for Social Security benefits.
- Guardians or other legal representatives acting on behalf of a minor.
- Individuals who may be unable to provide a birth certificate as proof of age.
Completing this form step by step
- Identify the parent completing the affidavit and enter their name.
- Provide the name of the child and their date of birth.
- Specify the hospital or clinic where the child was born and its address.
- Indicate the current address of the child.
- Attach the affidavit to the relevant application for benefits.
- Have the affidavit signed in front of a notary public.
Does this document require notarization?
This document requires notarization to meet legal standards. US Legal Forms provides secure online notarization powered by Notarize, allowing you to complete the process through a verified video call, available 24/7.
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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
Typical mistakes to avoid
- Failing to provide accurate information about the child's birth date.
- Not including the complete address of the birth facility.
- Omitting the purpose of the affidavit when attaching it to the application.
- Not having the form notarized, if required by state law.
Advantages of online completion
- Convenience of accessing and completing the form from home.
- Editability allows users to make necessary changes easily.
- Reliability of forms drafted by licensed attorneys for legal compliance.
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FAQ
Under SSI: If your child is younger than age 22 and is a student who regularly attends school, we exclude even more of his or her earnings each month. In 2021, disabled students younger than age 22 may exclude $1,930 of their monthly earnings, with an annual limit of $7,770, when calculating their income for SSI.
Importantly, Social Security benefits are counted as unearned income. For example, in 2017 a child with special needs living with one parent earning less than $3,065 a month in earned income would qualify for SSI. If all the parent's income is unearned, the monthly income limit would be $1,510.
To be allowed to claim your parent as a dependent, your parent's taxable income must be less than $4,200 for tax year 2019. This means that if your parent earns $4,200 or more, you aren't eligible to claim them as a dependent.
You can apply for benefits by calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting your local Social Security office. An appointment is not required, but if you call ahead and schedule one, it may reduce the time you spend waiting to apply.
If you are caring for your mother or father, you may be able to claim your parent as a dependent on your income taxes. This would allow you to get a $500 tax credit for him or her.
Within a family, a child can receive up to half of the parent's full retirement or disability benefit. If a child receives survivors benefits, they can get up to 75 percent of the deceased parent's basic Social Security benefit.It can be from 150 to 180 percent of the parent's full benefit amount.
Name of deceased. Social security number of deceased. Name of worker. Death date and state of residence of deceased. Name of applicant. Relationship to deceased. Next of kin or legal representative of deceased. Signature of applicant.
Being claimed as a dependent has no effect on the benefit, but Social Security does limit any wage income she receives while on disability.
Even if Page 3 2 you don't know both parents' Social Security numbers, you still can apply for a number for your child. Show us original documents proving your child's: U.S. citizenship; Age; and Identity. Show us documents proving your identity and your relationship to the child.
