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If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you. Important Note: PDFs you open from this page may default to opening within a browser, depending on your browser settings.
USE THIS APPLICATION TO: Apply for an original Social Security card . Apply for a replacement Social Security card . Change or correct information on your Social Security number record. IMPORTANT: You MUST provide a properly completed application and the required evidence before we can process your application.
You can complete an application for retirement, spouse's, Medicare, or disability benefits online. If you cannot submit your application online, call us at 1-800-772-1213 (TTY 1-800-325-0778) between 8 a.m. and 7 p.m..
An Application for a Social Security Card (Form SS-5) is used to request a new or replacement Social Security card from the Social Security Administration (SSA).
Apply for Benefits, Social Security. Benefits Application Terms of Service. I understand that I am entering a U.S. Government System to file a benefit application with the Social Security Administration. I understand that I need to provide the Social Security Administration information to process the benefit application.
1. I request that I be paid directly. CHECK HERE. and answer only items 3, 5, 6, and 8 before signing the form on page 4. I REQUEST THAT THE SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, OR SPECIAL VETERANS BENEFITS FOR THE CLAIMANT(S) NAMED ABOVE BE PAID TO ME AS REPRESENTATIVE PAYEE. Form SSA-11-BK (08-2009) EF (08-2009) Page 1. 6.
This page will guide you through the process of applying for retirement benefits when you’re ready to take that step. Our online application is a convenient way to apply on your own schedule, without an appointment. You can also apply by phone or by appointment at a Social Security office.
To get a replacement Social Security card for a child, you can use our online Social Security number and card application available at www.ssa.gov/number-card. You will start the application online and complete the process in a local Social Security ofice or Card Center.
You can complete the Part B SEP online or you can mail your completed CMS 40B, Application for Enrollment in Medicare - Part B (Medical Insurance) and CMS L564 - Request for Employment Information to your local Social Security office.
SEND OR BRING THE COMPLETED FORM TO YOUR LOCAL SOCIAL SECURITY OFFICE. You can find your local Social Security office through SSA’s website at www.socialsecurity.gov. Offices are also listed under U. S. Government agencies in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).