SSA SS-5 PDF Template

SSA SS-5 PDF Template

The SSA SS-5 form is an essential document used to apply for a Social Security card in the United States. This form is crucial for individuals seeking to establish their identity and gain access to various benefits. Ready to get started? Fill out the form by clicking the button below.

Article Guide

The SSA SS-5 form is a crucial document for anyone seeking to obtain a Social Security number (SSN) in the United States. This form is not only essential for new applicants, but it also serves individuals who need to replace a lost or stolen card, or those who are applying for a name change. Completing the SS-5 involves providing personal information such as your name, date of birth, and place of birth, along with details about your citizenship status. For children, parents or guardians must fill out the form, ensuring that all necessary documentation, such as proof of identity and age, is submitted. The process may seem straightforward, but understanding the requirements and gathering the right supporting documents can make a significant difference in how quickly your application is processed. Whether you're applying for the first time or updating your information, knowing the ins and outs of the SSA SS-5 form can help streamline your experience with the Social Security Administration.

SSA SS-5 Preview

Form SS-5 (12-2024) UF

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Social Security Administration

OMB No. 0960-0066

Application for a Social Security Card

Applying for a Social Security Card is free!

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. We can only accept original documents or documents certified by the custodian of the original record. Notarized copies or photocopies which have not been certified by the custodian of the record are not acceptable. We will return any documents submitted with your application. For assistance call us at 1-800-772-1213 or visit our website at www.socialsecurity.gov.

Original Social Security Card

To apply for an original card, you must provide at least two documents to prove age, identity, and U.S. citizenship or current lawful, work-authorized immigration status. If you are not a U.S. citizen and do not have DHS work authorization, you must prove that you have a valid non-work reason for requesting a card. See page 2 for an explanation of acceptable documents.

NOTE: If you are age 12 or older and have never received a Social Security number, you must apply in person.

Replacement Social Security Card

To apply for a replacement card, you must provide one document to prove your identity. If you were born outside the U.S., you must also provide documents to prove your U.S. citizenship or current, lawful, work-authorized status. See page 2 for an explanation of acceptable documents.

Changing Information on Your Social Security Record

To change the information on your Social Security number record (i.e., a name or citizenship change, or corrected date of birth) you must provide documents to prove your identity, support the requested change, and establish the reason for the change. For example, you may provide a birth certificate to show your correct date of birth. A document supporting a name change must be recent and identify you by both your old and new names. If the name change event occurred over two years ago or if the name change document does not have enough information to prove your identity, you must also provide documents to prove your identity in your prior name and/or in some cases your new legal name. If you were born outside the U.S. you must provide a document to prove your U.S. citizenship or current lawful, work-authorized status. See page 2 for an explanation of acceptable documents.

LIMITS ON REPLACEMENT SOCIAL SECURITY CARDS

Public Law 108-458 limits the number of replacement Social Security cards you may receive to 3 per calendar year and 10 in a lifetime. Cards issued to reflect changes to your legal name or changes to a work authorization legend do not count toward these limits. We may also grant exceptions to these limits if you provide evidence from an official source to establish that a Social Security card is required.

IF YOU HAVE ANY QUESTIONS

If you have any questions about this form or about the evidence documents you must provide, please visit our website at www.socialsecurity.gov for additional information as well as locations of our offices and Social Security Card Centers. You may also call Social Security at 1-800-772-1213. You can also find your nearest office or Card Center in your local phone book.

Form SS-5 (12-2024) UF

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EVIDENCE DOCUMENTS

The following lists are examples of the types of documents you must provide with your application and are not all inclusive. Call us at 1-800-772-1213 if you cannot provide these documents.

IMPORTANT: If you are completing this application on behalf of someone else, you must provide evidence that shows your authority to sign the application as well as documents to prove your identity and the identity of the person for whom you are filing the application. We can only accept original documents or documents certified by the custodian of the original record. Notarized copies or photocopies which have not been certified by the custodian of the record are not acceptable.

Evidence of Age

In general, you must provide your birth certificate. In some situations, we may accept another document that shows your age. Some of the other documents we may accept are:

U.S. hospital record of your birth (created at the time of birth)

Religious record established before age five showing your age or date of birth

Passport

Final Adoption Decree (the adoption decree must show that the birth information was taken from the original birth certificate)

Evidence of Identity

You must provide current, unexpired evidence of identity in your legal name. Your legal name will be shown on the Social Security card. Generally, we prefer to see documents issued in the U.S. Documents you submit to establish identity must show your legal name AND provide biographical information (your date of birth, age, or parents' names) and/or physical information (photograph, or physical description - height, eye and hair color, etc.). If you send a photo identity document but do not appear in person, the document must show your biographical information (e.g., your date of birth, age, or parents' names). Generally, documents without an expiration date should have been issued within the past two years for adults and within the past four years for children.

As proof of your identity, you must provide a:

U.S. driver's license; or

U.S. State-issued non-driver identity card; or

U.S. passport

If you do not have one of the documents above or cannot get a replacement within 10 work days, we may accept other documents that show your legal name and biographical information, such as a U.S. military identity card, Certificate of Naturalization, employee identity card, certified copy of medical record (clinic, doctor or hospital), health insurance card, Medicaid card, or school identity card/record. For young children, we may accept medical records (clinic, doctor, or hospital) maintained by the medical provider. We may also accept a final adoption decree, or a school identity card, or other school record maintained by the school.

If you are not a U.S. citizen, we must see your current U.S. immigration document(s) and your foreign passport with biographical information or photograph.

WE CANNOT ACCEPT A BIRTH CERTIFICATE, HOSPITAL SOUVENIR BIRTH CERTIFICATE, SOCIAL SECURITY CARD STUB OR A SOCIAL SECURITY RECORD as evidence of identity.

Evidence of U.S. Citizenship

In general, you must provide your U.S. birth certificate or U.S. Passport. Other documents you may provide are a Consular Report of Birth, Certificate of Citizenship, or Certificate of Naturalization.

Evidence of Immigration Status

You must provide a current unexpired document issued to you by the Department of Homeland Security (DHS) showing your immigration status, such as Form I-551, I-94, or I-766. If you are an international student or exchange visitor, you may need to provide additional documents, such as Form I-20, DS-2019, or a letter authorizing employment from your school and employer (F-1) or sponsor (J-1). We CANNOT accept a receipt showing you applied for the document. If you are not authorized to work in the U.S., we can issue you a Social Security card only if you need the number for a valid non-work reason. Your card will be marked to show you cannot work and if you do work, we will notify DHS. See page 3, item 5 for more information.

Form SS-5 (12-2024) UF

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HOW TO COMPLETE THIS APPLICATION

Complete and sign this application LEGIBLY using ONLY black or blue ink on the attached or downloaded form using only 8 ½” x 11” (or A4 8.25” x 11.7”) paper.

GENERAL: Items on the form are self-explanatory or are discussed below. The numbers match the numbered items on the form. If you are completing this form for someone else, please complete the items as they apply to that person.

4.Show the month, day, and full (4 digit) year of birth; for example, “1998” for year of birth.

5.If you check “Legal Alien Not Allowed to Work” or “Other,” you must provide a document from a U.S. Federal, State, or local government agency that explains why you need a Social Security number and that you meet all the requirements for the government benefit. NOTE: Most agencies do not require that you have a Social Security number. Contact us to see if your reason qualifies for a

Social Security number.

6., 7. Providing race and ethnicity information is voluntary and does not affect decisions on your application. We request this information for research and statistical purposes, to ensure all our customers receive fair and equal treatment.

9.B., 10.B. If you are applying for an original Social Security card for a child under age 18, you MUST show the parents' Social Security numbers unless the parent was never assigned a Social Security number. If the number is not known and you cannot obtain it, check the “unknown” box.

13.If the date of birth you show in item 4 is different from the date of birth currently shown on your Social Security record, show the date of birth currently shown on your record in item 13 and provide evidence to support the date of birth shown in item 4.

16.Show an address where you can receive your card 7 to 14 days from now.

17.WHO CAN SIGN THE APPLICATION? If you are age 18 or older and are physically and mentally capable of reading and completing the application, you must sign in item 17. If you are under age 18, you may either sign yourself, or a parent or legal guardian may sign for you. If you are over age 18 and cannot sign on your own behalf, a legal guardian, parent, or close relative may generally sign for you. If you cannot sign your name, you should sign with an "X” mark and have two people sign as witnesses in the space beside the mark. Please do not alter your signature by including additional information on the signature line as this may invalidate your application. Call us if you have questions about who may sign your application.

HOW TO SUBMIT THIS APPLICATION

In most cases, you can take or mail this signed application with your documents to any Social Security office. Any documents you mail to us will be returned to you. Go to https://secure.ssa.gov/apps6z/FOLO/fo001.jsp to find the Social Security office or Social Security Card Center that serves your area.

Form SS-5 (12-2024) UF

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PROTECT YOUR SOCIAL SECURITY NUMBER AND CARD

Protect your SSN card and number from loss and identity theft. DO NOT carry your SSN card with you. Keep it in a secure location and only take it with you when you must show the card; e.g., to obtain a new job, open a new bank account, or to obtain benefits from certain U.S. agencies. Use caution in giving out your Social Security number to others, particularly during phone, mail, email and Internet requests you did not initiate.

PRIVACY ACT STATEMENT

Collection and Use of Personal Information

Sections 202, 205(c), and 702 of the Social Security Act (Act), as amended, allow us to collect this information, which we will use to assign a Social Security number, issue a Social Security card, and make a timely determination concerning eligibility for Social Security benefits. Providing the information is voluntary, but not providing all or part of the information may prevent us from assisting you. As law permits, we may use and share the information you submit, including with other Federal agencies, contractors, and others, as outlined in the routine uses within System of Records Notices (SORN) 60-0058, 60-0090, 60-0103, and 60-0104, available at www.ssa.gov/privacy. The information you submit may also be used in computer matching programs to establish or verify eligibility for Federal benefit programs and to recoup debts under these programs. The Act also allows us to collect race and ethnicity information, which we will use for research and statistical purposes. Furnishing us this information is voluntary and will not be used in decisions about your application.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take between 5 and 60 minutes to read the instructions, gather the facts, and answer the questions. 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). You may send comments regarding this burden estimate or any other aspect of this collection, including suggestions for reducing this burden to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address, not the completed form.

File Properties

Fact Name Description
Purpose The SSA SS-5 form is used to apply for a Social Security card.
Eligibility Individuals of any age can apply for a Social Security card using this form.
Required Information Applicants must provide personal details such as name, date of birth, and place of birth.
Submission Method The completed form can be submitted online, by mail, or in person at a local Social Security office.
Governing Law The SSA SS-5 form is governed by federal regulations under the Social Security Act.

Instructions on Utilizing SSA SS-5

Completing the SSA SS-5 form is an important step in applying for a Social Security number. This process involves providing personal information that will be used to establish your identity and eligibility. Once the form is filled out, it can be submitted to the Social Security Administration for processing.

  1. Begin by downloading the SSA SS-5 form from the Social Security Administration's website or obtain a physical copy from a local Social Security office.
  2. At the top of the form, fill in your name as it appears on your birth certificate or legal documents.
  3. Provide your Social Security number if you have one. If you do not, leave this section blank.
  4. In the next section, enter your date of birth in the format requested, typically month, day, and year.
  5. Indicate your place of birth, including the city and state, or the country if born outside the United States.
  6. Complete the section on your gender by marking the appropriate box.
  7. Fill in your mother's full name and father's full name as they appear on their birth certificates.
  8. Provide your current mailing address, including the street address, city, state, and ZIP code.
  9. Enter your phone number where you can be reached.
  10. Complete the section regarding your citizenship status by marking the appropriate box.
  11. If applicable, fill in the section regarding your previous Social Security number or any other names you have used.
  12. Sign and date the form at the bottom, certifying that the information provided is accurate.
  13. Gather any required supporting documents, such as proof of identity or citizenship.
  14. Submit the completed form and any supporting documents to your local Social Security office or via mail as instructed.

Important Facts about SSA SS-5

What is the SSA SS-5 form?

The SSA SS-5 form is an application used to request a Social Security number (SSN) from the Social Security Administration (SSA). This form is essential for individuals who are applying for a new SSN or need to replace a lost or stolen card. It is also used by certain non-citizens who are eligible for a number.

Who needs to fill out the SSA SS-5 form?

Anyone who does not have a Social Security number or needs a replacement card must complete the SSA SS-5 form. This includes newborns, children, and adults who have never been issued an SSN. Additionally, individuals who have lost their card or need to update their name due to marriage or divorce should also submit this form.

Where can I obtain the SSA SS-5 form?

The SSA SS-5 form can be downloaded directly from the Social Security Administration’s official website. Alternatively, you can request a paper form by visiting your local SSA office or calling the SSA's toll-free number. Many libraries and community organizations also have copies available for public use.

What information is required on the SSA SS-5 form?

The form requires personal information such as your name, date of birth, place of birth, and parents' names. If you are applying for a replacement card, you will also need to provide details about your previous SSN, if known. Additional documentation may be required to verify your identity and eligibility, especially for non-citizens.

How do I submit the SSA SS-5 form?

You can submit the completed SSA SS-5 form in person at your local SSA office or by mailing it to the appropriate address provided on the form. If you choose to mail it, ensure that you send any required documents along with the application. It’s recommended to use a secure mailing method to protect your sensitive information.

Is there a fee to apply for a Social Security number using the SSA SS-5 form?

No, there is no fee for applying for a Social Security number or for obtaining a replacement card using the SSA SS-5 form. The Social Security Administration provides these services free of charge. Be cautious of any third-party services that may charge a fee for assistance.

How long does it take to receive my Social Security card after submitting the SSA SS-5 form?

Typically, if your application is processed without issues, you can expect to receive your Social Security card within 10 to 14 business days. However, processing times can vary based on the volume of applications and any additional verification needed. It’s advisable to check the SSA website for the most current processing times.

What should I do if I do not receive my card?

If you do not receive your Social Security card within the expected timeframe, you should contact the Social Security Administration for assistance. They can provide information on the status of your application and help resolve any issues that may have arisen during processing.

Can I apply for a Social Security number online?

Currently, the SSA SS-5 form cannot be submitted online for all applicants. However, certain individuals, such as those applying for a replacement card or those who are eligible for an SSN based on specific criteria, may be able to use the SSA’s online services. It’s important to check the SSA website for detailed instructions regarding online applications.

What if I make a mistake on the SSA SS-5 form?

If you realize that you have made a mistake on your SSA SS-5 form after submitting it, you should contact the Social Security Administration as soon as possible. They can guide you on the steps to correct the information. If the form has not been processed yet, you may be able to submit a new application with the correct details.

Common mistakes

Filling out the SSA SS-5 form, which is essential for obtaining a Social Security number, can be straightforward, but many people make common mistakes that can delay the process. One frequent error is providing incorrect personal information. This includes misspellings of names or incorrect dates of birth. Such inaccuracies can lead to complications in verifying identity and may require additional documentation.

Another mistake involves failing to sign the form. The SSA SS-5 requires a signature to validate the application. Without it, the application may be considered incomplete, leading to unnecessary delays. Ensure that the form is signed by the applicant or, in the case of minors, by a parent or guardian.

Some applicants overlook the need to provide proof of identity. The SSA requires specific documents to establish identity and eligibility. Submitting the form without the necessary identification can result in rejection. Always check the list of acceptable documents before submitting.

Inaccurate information about citizenship or immigration status is another common pitfall. Applicants must declare their citizenship accurately. Misrepresenting this information can have serious consequences, including denial of the application. It is crucial to be truthful and provide supporting documentation as required.

Many people also neglect to include their mailing address. The SSA needs a current address to send important correspondence. If this information is missing, it can lead to confusion and delays in processing the application.

Lastly, applicants sometimes fail to review the entire form before submission. Overlooking small details can lead to significant issues. Taking the time to double-check all entries can prevent many of these common mistakes, ensuring a smoother application process.

Documents used along the form

The SSA SS-5 form is essential for applying for a Social Security number, but it's often accompanied by other important documents. Each of these documents serves a specific purpose in verifying identity or eligibility. Here’s a list of forms and documents you may need to consider when submitting the SSA SS-5 form.

  • Birth Certificate: This document proves your date of birth and citizenship. It’s a primary form of identification required for the SS-5 application.
  • Passport: A valid U.S. passport can also serve as proof of identity and citizenship. If you have one, it may expedite the process.
  • Driver’s License or State ID: These forms of identification help verify your identity. They are often accepted as valid proof when applying for a Social Security number.
  • Immigration Documents: If you are not a U.S. citizen, you will need to provide documentation such as a green card or work visa to confirm your legal status.
  • Marriage Certificate: If your name has changed due to marriage, this document can help establish your identity and link your previous name to your current one.
  • Divorce Decree: Similar to a marriage certificate, this document can be used to clarify name changes and establish identity.
  • Social Security Card (if applicable): If you are applying for a replacement card, you will need to provide your current card or other identification to verify your identity.
  • Tax Documents: Previous tax returns or W-2 forms can serve as proof of income and may be requested in certain situations.
  • Medical Records: In some cases, especially for minors or individuals with disabilities, medical records may be required to verify identity or eligibility.
  • Proof of Residency: Documents like utility bills or lease agreements can help establish your current address, which may be necessary for the application process.

Gathering these documents can streamline your application process for a Social Security number. Make sure to check the specific requirements based on your situation to avoid any delays. Being prepared will make the entire experience smoother and more efficient.

Similar forms

The SSA SS-5 form is an important document used to apply for a Social Security number. Several other documents share similarities with the SS-5 in terms of purpose or information required. Here’s a list of six documents that are comparable to the SSA SS-5 form:

  • Form I-9: This document is used for employment verification in the United States. Like the SS-5, it requires proof of identity and eligibility to work, ensuring that the applicant provides accurate personal information.
  • Form W-4: This form is filled out by employees to determine the amount of federal income tax withholding from their paychecks. Similar to the SS-5, it requires personal information such as name, address, and Social Security number.
  • Form 1040: This is the standard individual income tax return form. It requires a Social Security number and similar personal information, linking it to the SS-5 in terms of identifying the taxpayer.
  • Driver’s License Application: When applying for a driver’s license, individuals must provide personal information, including proof of identity and residency. This process is akin to the SS-5, which also aims to verify identity.
  • Passport Application (Form DS-11): This form is used to apply for a U.S. passport. It requires personal details and proof of citizenship, similar to how the SS-5 collects information to issue a Social Security number.
  • Voter Registration Form: This document is used to register to vote in elections. It collects personal information, including name and address, much like the SS-5, which gathers essential details for identification purposes.

Each of these documents plays a crucial role in various aspects of life in the U.S., from employment to voting, while sharing common requirements with the SSA SS-5 form.

Dos and Don'ts

When filling out the SSA SS-5 form, it’s important to pay attention to details. Here are some guidelines to help you through the process.

  • Do double-check all personal information for accuracy.
  • Do provide your full legal name as it appears on your documents.
  • Do ensure you include your date and place of birth.
  • Do sign and date the form before submitting it.
  • Don't leave any required fields blank.
  • Don't use pencil or any form of correction fluid on the form.

Following these tips can help ensure your application process goes smoothly. Take your time, and don’t hesitate to ask for assistance if you need it.

Misconceptions

The SSA SS-5 form is an important document used to apply for a Social Security number. However, there are several misconceptions surrounding this form that can lead to confusion. Here are eight common misconceptions:

  • The SSA SS-5 form is only for U.S. citizens. This is not true. While U.S. citizens use this form to apply for a Social Security number, non-citizens who meet certain criteria can also use it.
  • You need to provide a birth certificate to complete the SSA SS-5 form. Although a birth certificate is often helpful, it is not always required. Other forms of identification may suffice, depending on the applicant's situation.
  • The SSA SS-5 form can only be submitted in person. This is a misconception. While submitting the form in person is an option, applicants can also mail it to the appropriate Social Security office.
  • You must be a certain age to apply using the SSA SS-5 form. There is no minimum age requirement. Infants and children can also be assigned a Social Security number using this form.
  • The SSA SS-5 form is only for new applicants. This is misleading. Individuals can also use the form to update their information, such as a name change.
  • You will receive your Social Security card immediately after submitting the SSA SS-5 form. In reality, it typically takes several weeks to process the application and mail the card.
  • The SSA SS-5 form is complicated and difficult to fill out. While it may seem daunting, the form is relatively straightforward. Most applicants can complete it with basic information.
  • You can only apply for a Social Security number once. This is incorrect. If you lose your Social Security card or need to change your information, you can fill out the SSA SS-5 form again.

Understanding these misconceptions can help streamline the application process and ensure that individuals get the necessary assistance with their Social Security needs.

Key takeaways

Filling out the SSA SS-5 form is an important step for obtaining a Social Security number. Here are some key takeaways to keep in mind:

  • The form requires personal information such as your name, date of birth, and place of birth.
  • It is essential to provide accurate and complete information to avoid delays in processing.
  • You can submit the form in person at your local Social Security office or by mail, depending on your preference.
  • Keep a copy of the completed form for your records, as it may be useful for future reference.