Ssa 3369 bk 04 2011 form-2025

1. Click ‘Get Form’ to open the SSA 3369 BK 04 2011 form in the editor.
2. Begin with Section 1, providing the disabled person's name, Social Security number, and daytime telephone number. Ensure all information is accurate and clearly printed.
3. Move to Section 2, where you will list all jobs held in the last 15 years. For each job, include the job title, type of business, and dates worked. Use separate pages for detailed descriptions if necessary.
4. For each job listed, provide additional details such as rate of pay, hours worked per day/week, and a description of daily tasks. Be thorough in explaining any technical skills or equipment used.
5. In Section 3 (Remarks), add any extra information that could not fit in previous sections. Make sure to reference the corresponding page numbers for clarity.
6. Finally, ensure that you complete the bottom of Page 8 with your name and contact information if someone else is filling out the form on behalf of the disabled person.

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