Ssa 150 2025

See details

4.9 out of 5

35 votes

The document is a Modified Benefit Formula Questionnaire from the Social Security Administration, designed to collect information regarding an individual's pension or annuity and its impact on their Social Security benefits. It outlines the necessary personal information required, explains the voluntary nature of providing this information, and details how it may be used in determining Social Security benefits. The form also includes instructions for reporting changes in pension status and emphasizes the importance of accurate information.

Here's how it works

01. Edit your ssa form 150 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 form ssa 150 via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out SSA 150 with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the SSA 150 in the editor.
Begin by entering the name and address of the agency or organization from which you receive your pension or annuity. Ensure to include the ZIP code for accuracy.
Next, specify the period(s) of employment that your pension is based on. Fill in both covered and non-covered employment dates, using 'unknown' if necessary.
Indicate the periods of employment after 1956 that are not covered by Social Security. Again, use 'unknown' if you do not have this information.
Enter the monthly amount of your pension or annuity before any deductions. If you are unsure, simply write 'unknown'.
If applicable, provide details about any lump sum payments received instead of a monthly pension, including amounts and relevant time periods.
Utilize the remarks section for any additional information that may be pertinent to your application.

Start filling out your SSA 150 form online for free today!

See more ssa 150 versions

We've got more versions of the ssa 150 form. Select the right ssa 150 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2014	4.9 Satisfied (35 Votes)
2003	4.4 Satisfied (31 Votes)

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.

Can I type my eSignature on my ssa 150?

Yes, a typed name is accepted as a legitimate electronic signature when you create it on your document utilizing a compliant solution like DocHub. Simply add your ssa 150 to our editor, click Sign in the top tool pane → Create your signature → Type your name in the appropriate tab, and decide how it will look on your document.

How do you get ssa 58 for my state?

If you are looking for a state-specific ssa 58 sample, you will find it in our DocHub Forms & Templates catalog. Use the search field, enter your form’s name, and search through the results for your state. You can also filter out irrelevant results while browsing our catalog by groups.

Try more PDF tools