Appearance before 2026

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The document is a waiver form from the Social Security Administration allowing a claimant to forgo their right to appear in person before an Administrative Law Judge. It explains the implications of this decision, including the opportunity to present written evidence and the option to change their mind before a decision is made. The form also includes a Privacy Act notice regarding the use of personal information.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the 'Claimant' field. If the wage earner is different, fill that section; otherwise, leave it blank.
Input your Social Security Claim Number in the designated fields. Ensure accuracy to avoid processing delays.
Read the PRIVACY ACT statement carefully. This informs you about how your information will be used.
In the provided space, clearly state your reason for waiving your right to a personal appearance before an Administrative Law Judge.
Sign and date the form at the bottom. If applicable, include the signature of an authorized representative.

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