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Submitting Forms and Supporting Documents
You can electronically complete, upload, and submit select forms to Social Security using the Upload Documents feature. You can also fax or mail any paper form to your local office, unless otherwise instructed by the form.

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SS-5 Application for a Social Security Card

SS-5-FS Application for a Social Security Card (Outside of the U.S.)

CMS-40B Application for Enrollment in Medicare - Part B (Medical Insurance)

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CMS-1763 Request for Termination of Premium Part A, Part B, or Part B Immunosuppressive Drug Coverage

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CMS-L564 Request for Employment Information

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HA-85 Request to Withdraw a Hearing Request

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HA-86 Request to Withdraw an Appeals Council Request for Review

HA-501-U5 Request for Hearing by Administrative Law Judge

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HA-510 Waiver of Timely Written Notice of Hearing

HA-520 Request for Review of Hearing Decision/Order

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HA-539 Notice Regarding Substitution of Party Upon Death of Claimant

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HA-4608 Waiver of Your Right to Personal Appearance Before an Administrative Law Judge

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HA-4631 Claimant's Recent Medical Treatment

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HA-4632 Claimant's Medications

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HA-4633 Claimant's Work Background

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IRS SS-4 Application for Employer Identification Number

IRS W-4V Voluntary Withholding Request

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SSA-1-BK Application for Retirement Insurance Benefits

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SSA-2-BK Application for Wife's or Husband's Insurance Benefits

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SSA-3 Marriage Certification

SSA-4-BK Application for Child's Insurance Benefits

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SSA-5-BK Application For Mother's Or Father's Insurance Benefits

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SSA-7-F6 Application for Parent's Insurance Benefits

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SSA-8 Application for Lump-Sum Death Payment

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SSA-10 Application for Widow's or Widower's Insurance Benefits

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SSA-16 Application for Disability Insurance Benefits

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SSA-21 Supplement to Claim of Person Outside the United States

SSA-24 Application for Survivors Benefits (Payable Under Title II of the Social Security Act)

SSA-25 Certification of Election for Reduced Spouse's Benefits

SSA-44 Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event

SSA-88 Pre-Approval Form for Consent Based Social Security Number Verification (CBSV)

SSA-89 Authorization for the Social Security Administration To Release Social Security Number (SSN) Verification

SSA-131 Employer Report of Special Wage Payments

SSA-150 Modified Benefits Formula Questionnaire

SSA-186 Temporary Institutionalization Statement to Maintain Household and Physician Certification

SSA-199 Vocational Rehabilitation Provider Claim

SSA-263 Waiver of Supplemental Security Income Payment Continuation

SSA-268 Patient Acknowledgement Form for Influenza Vaccination

SSA-295 Disability Determination Ready Claim Certification

SSA-308 Modified Benefits Formula Questionnaire, Foreign Pension

SSA-371 Request For Reinstatement - Title II

SSA-372 Request For Reinstatement - Title XVI

SSA-437-BK Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration

SSA-454-BK Continuing Disability Review Report

SSA-455 Disability Update Report

SSA-521 Request for Withdrawal of Application

SSA-545-BK Plan for Achieving Self-Support

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SSA-546 Worker's Compensation/Public Disability Questionnaire

SSA-552 Dedicated Account Use of Funds Statement

SSA-561 Request for Reconsideration

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SSA-632-BK Request for Waiver of Overpayment Recovery

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SSA-634 Request for Change in Overpayment Recovery Rate

SSA-640 Financial Disclosure for Civil Monetary Penatly (CMP) Debt

SSA-671 Railroad Employment Questionnaire

SSA-711 Request for Deceased Individual's Social Security Record

SSA-714 You can make your payment by Credit Card

SSA-721 Statement of Death by Funeral Director

SSA-723 Statement Regarding the Inferred Death of an Individual by Reason of Continued and Unexplained Absence

SSA-731 Notice to Electronic Information Exchange Partners to Provide Contractor List

SSA-753 Statement Regarding Marriage

SSA-754-F5 Statement of Marital Relationship

SSA-760 Certificate of Support

SSA-765 Response to Notice of Revised Determination

SSA-766 Statement of Self-Employment Income

SSA-769 Request for Change in Time/Place of Disability Hearing

SSA-770-U4 Notice Regarding Substitution of Party Upon Death of Claimant Reconsideration of Disability Cessation

SSA-773 Waiver Of Right To Appear - Disability Hearing

SSA-781 Certificate of Responsibility for Welfare and Care of Child

SSA-783 Statement Regarding Contributions

SSA-788 Statement of Care and Responsibility for Beneficiary

SSA-789 Request for Reconsideration - Disability Cessation

SSA-792 Statutory Benefit Continuation Election Statement

SSA-795 Statement of Claimant or Other Persons

SSA-820-BK Work Activity Report (Self-Employed Person)

SSA-821-BK Work Activity Report

SSA-827 Authorization to Disclose Information to the Social Security Administration

SSA-1020 Application For Help With Medicare Prescription Drug Plan Costs

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SSA-1021 Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs

SSA-1199 International Direct Deposit (IDD)

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SSA-1372-BK Advanced Notice of Termination of Child's Benefits

SSA-1372-BK-FC Advanced Notice of Termination of Child's Benefits (Foreign Claims)

SSA-1383 Student Reporting Form

SSA-1383-FC Reporting to Social Security Administration by Student Outside the United States

SSA-1391 Employment Network Payment Request Form

SSA-1458 Certification By Religious Group

SSA-1560 Petition For Authorization To Charge And Collect A Fee For Services Before The Social Security Administration

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SSA-1691 Eligible Non-Attorney Representative Application

SSA-1693 Fee Agreement for Representation Before the Social Security Administration

SSA-1694 Request for Business Entity Taxpayer Information

SSA-1696 Claimant's Appointment of Representative

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SSA-1696-SUP1 Claimant's Revocation of the Appointment of a Representative

SSA-1696-SUP2 Representative's Withdrawal of Acceptance of Appointment

SSA-1699 Registration for Appointed Representative Services and Direct Payment

SSA-1724-F4 Claim for Amounts due in case of a Deceased Beneficiary

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SSA-1945 Statement Concerning Your Employment in a Job Not Covered by Social Security

SSA-2010 Statement for Determining Continuing Entitlement for Special Veterans Benefits (SVB)

SSA-2032-BK Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate

SSA-2490 Application For Benefits Under a U.S. International Social Security Agreement

SSA-2512 Pre-1957 Military Service Federal Benefit Questionnaire

SSA-2519 Child Relationship Statement

SSA-2574 Information About Joint Checking/Savings Accounts Supplemental Security Income

SSA-2855 Statement of Funds you Received

SSA-2935 Authorization to the Social Security Administration to Obtain Personal Information

SSA-3033 Employee Work Activity Questionnaire

SSA-3105 Important information about your appeal, waiver rights, and repayment options

SSA-3288 Consent for Release of Information

SSA-3368-BK Disability Report - Adult

SSA-3369-BK Work History Report

SSA-3373-BK Function Report - Adult

SSA-3375-BK Function Report - Child Birth to 1st Birthday

SSA-3376-BK Function Report - Child Age 1 to 3rd Birthday

SSA-3377-BK Function Report - Child Age 3 to 6th Birthday

SSA-3378-BK Function Report - Child Age 6 to 12th Birthday

SSA-3379-BK Function Report - Child Age 12 to 18th Birthday

SSA-3380-BK Function Report - Adult - Third Party Form

SSA-3441-BK Disability Report - Appeal

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SSA-3820-BK Disability Report - Child

SSA-3830 Certification of Low Birth Weight for SSI Eligibility

SSA-3881-BK Questionnaire for Children Claiming SSI Benefits

SSA-3885 Government Pension Questionnaire

SSA-4111 Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits

SSA-4162 Child Care Dropout Questionnaire

SSA-4178 Marital Relationship Questionaire

SSA-4814 Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection

SSA-4815 Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection

SSA-5062 Claimant's Statement about Loan of Food or Shelter

SSA-5064 Claimant's Statement About Loan For Shelter

SSA-5665-BK Teacher Questionnaire

SSA-5666 Request for Administrative Information

SSA-7004 Request for Social Security Statement

SSA-7008 Request for Correction of Earnings Record

SSA-7011-F4 Statement of Employer

SSA-7050-F4 Request for Social Security Earnings Information

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SSA-7104 Partnership Questionnaire

SSA-7156 Farm Self Employment Questionnaire

SSA-7157-F4 Farm Arrangement Questionnaire

SSA-7160 Employment Relationship Questionnaire

SSA-7163 Questionnaire about Employment or Self Employment

SSA-7163A Supplemental Statement Regarding Farming Activities

SSA-8000-BK Application for Supplemental Security Income (SSI)

SSA-8001-BK Application for Supplemental Security Income (SSI) (Deferred or Abbreviated)

SSA-8011-F3 Statement of Household Expenses and Contributions

SSA-8240 Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers

SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information

SSA-8552 Interview Confirmation

Most, but not all, forms are available for electronic submission.

For security purposes, you need to complete an additional identity verification to electronically submit the following forms:

Number	Name
SSA-454-BK	Continuing Disability Review Report
SSA-827	Authorization to Disclose Information to the Social Security Administration
SSA-2574	Information About Joint Checking/Savings Accounts Supplemental Security Income
SSA-2935	Authorization to the Social Security Administration to Obtain Personal Information
SSA-8510	Authorization for the Social Security Administration to Obtain Personal Information