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Form Approved OMB No 0960-0045 SOCIAL SECURITY-2025

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The document is Form SSA-795, a statement used by the Social Security Administration to collect information from claimants or other individuals regarding efforts to pursue U.S. Citizenship for determining eligibility for Supplemental Security Income (SSI) benefits. It includes privacy and usage information about the collected data, instructions for completion, and legal declarations regarding the accuracy of the provided information.

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