Understanding SSI - Living Arrangements - Social Security Administration 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Customer Name, Client ID, Case Manager, and Telephone in the designated fields at the top of the form.
3. In Section I, landlords or rental agents should fill out tenant details including Date of Occupancy and Address. Specify the Rent charged and select whether it is weekly, monthly, or other.
4. Indicate if the rent includes utilities such as Heat, Electric, Cooking, Water, and Air Conditioning by checking 'Yes' or 'No'.
5. If applicable, list any separate utility costs paid by the tenant along with their frequency and amounts in Section I.
6. Complete Section II by listing all individuals living with the tenant and their relationship to them.
7. Finally, ensure both landlord/rental agent and tenant sign and date the form before submission.

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