Email: serssrs 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the 'Member Information' section. Fill in your name (last, first, middle), SSN (last 4 digits) or Member ID, and your complete address including street, city, state, and zip code.
3. Next, provide your phone number(s) for home and cell. Ensure that these numbers are accurate for any follow-up communications.
4. Input your email address and date of birth in the designated fields. This information is crucial for identification purposes.
5. Review the authorization statement carefully. It outlines who can disclose your information and what type of information will be shared. Make sure you understand this before proceeding.
6. Sign the form where indicated to certify that all provided information is correct. Remember to include the date of your signature.
7. If applicable, have a witness over the age of 18 sign and date the form as well.

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