SSA SS-5 Template

SSA SS-5 Template

The SSA SS-5 form is an application used to request a Social Security number. This form is essential for anyone looking to obtain a new Social Security card or replace a lost one. Ready to fill out the form? Click the button below to get started!

Table of Contents

The SSA SS-5 form plays a crucial role in the process of obtaining a Social Security number, which is essential for various aspects of life in the United States, including employment, taxation, and accessing government services. This application form is utilized by individuals seeking to apply for a new Social Security number, request a replacement card, or update personal information. It is vital for U.S. citizens, non-citizen residents, and certain non-citizens who are legally present in the country. The form requires applicants to provide personal details such as their name, date of birth, and place of birth, along with information about their parents. Additionally, it may require documentation to verify identity and citizenship status. Understanding the importance of the SSA SS-5 form and the correct procedures for completing it can help individuals navigate the often-complex landscape of Social Security benefits and ensure compliance with federal regulations.

SSA SS-5 Sample

Form SS-5 (12-2024) UF

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Discontinue Prior Editions

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.

Document Attributes

Fact Name Description
Purpose The SSA SS-5 form is used to apply for a Social Security card.
Eligibility Anyone can apply for a Social Security number, including U.S. citizens and non-citizens.
Required Information The form requires personal details such as name, date of birth, and place of birth.
Submission Methods You can submit the form online, by mail, or in person at your local Social Security office.
Processing Time Processing typically takes about 10 to 14 days after the application is received.
State-Specific Forms Some states may have additional requirements; consult state laws for details.

SSA SS-5: Usage Instruction

Filling out the SSA SS-5 form is an important step in applying for a Social Security number. Once completed, you will need to submit the form along with any required documents to the appropriate Social Security Administration office. This process can help you obtain the identification necessary for various services and benefits.

  1. Begin by downloading the SSA SS-5 form from the Social Security Administration website or obtaining a physical copy from your local SSA office.
  2. At the top of the form, fill in your name as you want it to appear on your Social Security card. Make sure to include your first name, middle initial, and last name.
  3. Provide your Social Security number if you already have one. If this is your first application, leave this section blank.
  4. Enter your date of birth. Use the format MM/DD/YYYY to ensure clarity.
  5. Fill in your place of birth, including the city and state, or the country if born outside the U.S.
  6. Indicate your gender by checking the appropriate box for male or female.
  7. Provide your current address. Include the street address, city, state, and ZIP code.
  8. List your phone number. This can be helpful if the SSA needs to contact you regarding your application.
  9. In the section for parents’ information, enter your mother’s and father’s names, including their Social Security numbers if applicable.
  10. Complete the section regarding your citizenship status. Check the appropriate box to indicate if you are a U.S. citizen, a lawful permanent resident, or a non-citizen.
  11. Sign and date the form at the bottom. Make sure to sign your name as it appears at the top of the form.
  12. Gather any required documents, such as proof of identity and age, and attach them to your completed form.
  13. Submit the form and documents either in person at your local SSA office or by mailing them to the appropriate address provided on the form.

Frequently Asked Questions

  1. What is the SSA SS-5 form?

    The SSA SS-5 form is an application used to request a Social Security card. This form is necessary for individuals who are applying for a new card, replacing a lost card, or changing their name on an existing card.

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

    Anyone who needs a Social Security card must complete the SSA SS-5 form. This includes U.S. citizens, non-citizen residents, and individuals applying for a card for the first time.

  3. Where can I obtain the SSA SS-5 form?

    The SSA SS-5 form can be obtained online through the Social Security Administration's website. Additionally, it is available at local Social Security offices and some public libraries.

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

    The form requires personal information such as:

    • Full name
    • Date of birth
    • Place of birth
    • Parent's names
    • Social Security number (if applicable)
    • Address
    • Gender
  5. How do I submit the SSA SS-5 form?

    You can submit the SSA SS-5 form in person at your local Social Security office. Alternatively, you can mail the completed form to the address specified on the form itself. Ensure that you include any required documents.

  6. What documents do I need to provide with the SSA SS-5 form?

    When submitting the SSA SS-5 form, you may need to provide proof of identity. This can include:

    • Birth certificate
    • Driver's license
    • Passport
    • Other government-issued identification
  7. How long does it take to receive my Social Security card?

    Typically, it takes about 10 to 14 business days to receive your Social Security card after your application has been processed. However, processing times may vary based on the volume of applications.

  8. Can I check the status of my SSA SS-5 application?

    Yes, you can check the status of your application by contacting the Social Security Administration directly. They can provide updates on the processing of your request.

  9. What should I do if my Social Security card is lost or stolen?

    If your Social Security card is lost or stolen, you should complete the SSA SS-5 form to request a replacement card. Additionally, consider monitoring your credit report and report the loss to the appropriate authorities to prevent identity theft.

Common mistakes

Completing the SSA SS-5 form, which is essential for applying for a Social Security number, can be straightforward. However, many individuals make common mistakes that can delay the process. Understanding these errors can help ensure a smoother application experience.

One frequent mistake is providing incorrect personal information. This includes misspellings of names or inaccurate dates of birth. Such errors can lead to confusion and may require additional documentation to correct. It is crucial to double-check all entries against official documents.

Another common issue arises when applicants fail to sign the form. The SSA SS-5 requires a signature to validate the application. Without it, the application cannot be processed, leading to unnecessary delays. Always ensure that the form is signed before submission.

Many people overlook the need to provide proof of identity and citizenship. The SSA requires specific documents to accompany the SS-5 form. Submitting incomplete documentation can result in a rejection of the application. It is advisable to review the list of acceptable documents carefully.

Additionally, some applicants neglect to provide their parents' information. This includes the names and Social Security numbers of parents, if applicable. Missing this information can complicate the application process, as the SSA may need to verify familial connections.

Another mistake involves not using the correct mailing address for submission. Applicants often send the form to the wrong office, which can lead to delays. It is important to verify the appropriate address based on the applicant's location and circumstances.

Lastly, some individuals fail to keep a copy of their completed form. This can be problematic if questions arise later or if the application is lost. Retaining a copy ensures that applicants have a record of what they submitted, which can be invaluable for follow-up inquiries.

By being aware of these common mistakes, individuals can navigate the SSA SS-5 form process with greater ease. Taking the time to review and verify all information can lead to a more efficient application experience.

Documents used along the form

The SSA SS-5 form is used to apply for a Social Security number. It is often accompanied by several other documents that help establish identity, citizenship, and eligibility. Below is a list of common forms and documents that may be required alongside the SSA SS-5 form.

  • Birth Certificate: This document serves as proof of an individual's date of birth and citizenship. It is typically required for first-time applicants or those who are applying for a replacement Social Security card.
  • Passport: A valid passport can be used as a form of identification and proof of citizenship. It is especially useful for individuals who may not have a birth certificate readily available.
  • Driver’s License or State ID: A government-issued photo identification helps verify an individual’s identity. It is often required to confirm the name and date of birth provided on the SSA SS-5 form.
  • Immigration Documents: For non-citizens, documents such as a Permanent Resident Card or a work visa may be necessary. These documents establish legal residency and eligibility to work in the United States.

Gathering these documents in advance can facilitate the application process for a Social Security number. Each document plays a crucial role in verifying the applicant's identity and eligibility.

Similar forms

The SSA SS-5 form is an important document for obtaining a Social Security number. Several other documents serve similar purposes in various contexts. Here are nine documents that share similarities with the SSA SS-5 form:

  • Form I-9: Used for verifying employment eligibility in the United States, it requires personal information and identification documents, much like the SS-5.
  • Passport Application Form: This form requests personal details and proof of identity, similar to the SS-5, which also seeks identification for a Social Security number.
  • Driver's License Application: When applying for a driver's license, individuals provide personal information and proof of residency, paralleling the information required on the SS-5.
  • Voter Registration Form: This document collects personal details to register individuals to vote, akin to the SS-5's collection of information for a Social Security number.
  • Medicare Application: To enroll in Medicare, individuals must provide personal information and proof of age, similar to the requirements of the SS-5.
  • State ID Application: Similar to the driver's license application, it requires personal information and identification, reflecting the SS-5’s purpose.
  • Employment Application: This form often requests personal details and identification, just like the SS-5 when applying for a Social Security number.
  • Tax Form W-4: Used for withholding allowances, it requires personal information, similar to the SS-5's need for identification for tax purposes.
  • School Enrollment Form: This document gathers personal information for student registration, mirroring the SS-5's function of collecting personal data.

Dos and Don'ts

When filling out the SSA SS-5 form, it's important to follow certain guidelines to ensure your application is processed smoothly. Here are some dos and don'ts to keep in mind:

  • Do provide accurate information. Double-check all entries to avoid mistakes.
  • Do use black or blue ink. This ensures clarity and legibility.
  • Do sign and date the form. An unsigned form can lead to delays.
  • Do include your Social Security number if you have one. This helps in processing your application.
  • Don't leave any required fields blank. Fill in all necessary information.
  • Don't use white-out or correction fluid. If you make a mistake, simply cross it out and write the correct information above.

By following these guidelines, you can help ensure that your SSA SS-5 form is completed correctly and efficiently.

Misconceptions

The SSA SS-5 form is essential for obtaining a Social Security number. However, several misconceptions surround this form. Here are four common misunderstandings:

  • Misconception 1: The SS-5 form can only be submitted in person.
  • Many people believe they must visit a Social Security office to submit the SS-5 form. In reality, you can mail the completed form along with the required documents to your local Social Security office.

  • Misconception 2: Only U.S. citizens can apply for a Social Security number using the SS-5 form.
  • This is not true. Non-citizens, such as lawful permanent residents, can also use the SS-5 form to apply for a Social Security number.

  • Misconception 3: You need a birth certificate to complete the SS-5 form.
  • While a birth certificate is a common document, it is not the only option. Other documents, such as a passport or a hospital record, may also suffice as proof of age and identity.

  • Misconception 4: The SS-5 form is only for children.
  • Some people think the SS-5 form is exclusively for children. Adults can also use this form to apply for their Social Security number, especially if they never received one at birth.

Key takeaways

The SSA SS-5 form is essential for individuals seeking to apply for a Social Security Number (SSN) or to request a replacement card. Understanding the key aspects of this form can streamline the application process and ensure accuracy.

  • Eligibility: The form is available for U.S. citizens, permanent residents, and non-citizens who meet specific criteria.
  • Required Information: Applicants must provide personal details, including name, date of birth, and proof of identity.
  • Submission Methods: The completed form can be submitted online, by mail, or in person at a Social Security Administration office.
  • Supporting Documents: Along with the form, individuals must include original documents that verify their identity and immigration status.
  • Processing Time: After submission, processing typically takes 10 to 14 days, but it may vary depending on the volume of applications.

By adhering to these guidelines, individuals can facilitate a smoother experience when applying for or replacing their Social Security Number.