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SSN (last 4 digits): XXX-XX-

SSN (last 4 digits): XXX-XX- 2025

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The document is a limited release form for medical/health care information required by the State of Maine Workers’ Compensation Board. It authorizes health care providers to release relevant medical records related to a specific injury or condition to the employer or insurer for the purpose of determining compensability of a workers' compensation claim. The form outlines the rights of the employee, including the voluntary nature of completion, limitations on the information released, and conditions for revocation.

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Versions	Form popularity	Fillable & printable
2018	4.9 Satisfied (50 Votes)
2013	4.2 Satisfied (59 Votes)

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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.

How much money is a Social Security number worth?

The Reality. There is no monetary value to a birth certificate or a social security number/EIN, and TreasuryDirect accounts must be funded by the owner (from the owners personal bank account) to have any value.

How do I find my last 4 digit SSN?

Look at your Social Security card for your Social Security number and the four numbers at the end is the four numbers at the end of your Social Security number. There is no code. Its just your number.

What documents show the last 4 digits of SSN?

Only the last four digits of a Social Security Number (SSN) are displayed on court documents.

How do I get my $16728 Social Security bonus?

The U.S. government created Social Security numbers in 1936 to track how much money Americans make during their lifetime and calculate Social Security benefits. You need a Social Security number to get a job, collect government benefits, and use for identification. You should be careful about sharing your number.

What do the last 4 digits of my SSN mean?

The nine-digit SSN is composed of three parts: The first set of three digits is called the Area Number. The second set of two digits is called the Group Number. The final set of four digits is the Serial Number.