Home
Forms Library
Statement of claimant or other person example

Statement of claimant or other person example 2025

statement of claimant or other person example Preview on Page 1

Show details

4.5 out of 5

52 votes

The document is a form from the Social Security Administration (SSA) titled 'Statement of Claimant or Other Person.' It is used to report out-of-pocket expenses related to medications for individuals with disabilities who are applying for Supplemental Security Income (SSI) benefits. The form requires details about the claimant's medications, associated costs, and proof of these expenses. It also includes privacy information regarding the use of personal data provided in the form.

Here's how it works

01. Edit your statement of claimant or other person example online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send how to fill out statement of claimant or other person via email, link, or fax. You can also download it, export it or print it out.

How to rapidly redact Statement of claimant or other person example online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the best editor for modifying your paperwork online. Adhere to this straightforward guide to edit Statement of claimant or other person example in PDF format online for free:

Sign up and log in. Create a free account, set a secure password, and proceed with email verification to start managing your templates.
Upload a document. Click on New Document and choose the form importing option: add Statement of claimant or other person example from your device, the cloud, or a protected link.
Make changes to the sample. Utilize the upper and left panel tools to modify Statement of claimant or other person example. Add and customize text, images, and fillable areas, whiteout unneeded details, highlight the important ones, and provide comments on your updates.
Get your paperwork accomplished. Send the form to other parties via email, generate a link for quicker file sharing, export the sample to the cloud, or save it on your device in the current version or with Audit Trail included.

Try all the benefits of our editor right now!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How can I send my [KEY] for eSignature?

Upload your [KEY] to DocHub (after you’ve set up an account for this). If you need to fill out fields in it, use appropriate tools from the upper pane. For instance, drop Signature Fields, assign each to specific party, and click on Sign → Request signatures from others. Customize your message for your recipients and click Send Request. You can also send your paperwork by fax or as a Signing link instead of using email (you’ll find these options by navigating to the Menu → Send)

How do you edit [KEY] on iOS?

You can easily edit and complete your [KEY] on any iOS gadget. Open an internet browser of your liking, go to the DocHub website, authorize or create a new account, add your file for editing, and make your desired changes. Our service is mobile-friendly, so using its functions on your phone will be a no-brainer, even on the first try.

Try more PDF tools