New jersey social security 2026

1. Click ‘Get Form’ to open the New Jersey Social Security form in the editor.
2. Begin by filling in the worker's name and Social Security number in Part I. Ensure accuracy as this information is crucial for processing.
3. Next, provide the employer's name and address along with the date of injury. This helps establish the context of the request.
4. Indicate whether you need 80% ACE only or 80% ACE plus Social Security benefits by checking the appropriate box.
5. Have the WC representative or attorney sign and date the form at the bottom of Part I, ensuring that any requests from an attorney include a signed authorization.
6. In Part II, if applicable, answer whether the worker has applied for social security benefits and specify the type of benefit if 'yes'.
7. Complete additional fields regarding claim status, entitlement amounts, and auxiliary beneficiaries as required.
8. Finally, ensure that an SSA representative signs and dates Part II before submitting your request.

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