Form Approved OMB No 0960-0045 SOCIAL SECURITY-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of the wage earner, self-employed person, or SSI claimant in the designated field. Ensure accuracy as this information is crucial for processing.
3. Next, input the Social Security number in the provided format. Double-check for any errors to avoid delays.
4. If you are not the wage earner, fill in your name and relationship to them. This helps clarify your connection and purpose for submitting the form.
5. Review the Privacy Act Statement carefully. It outlines how your information will be used and emphasizes that providing accurate details is essential for timely benefit decisions.
6. Sign and date the form at the bottom. If you are signing by mark (X), ensure two witnesses sign as well, including their addresses.
7. Finally, send the completed form to your local Social Security office as instructed. You can find contact details online or via phone.

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