All forms are FREE. Not all forms are listed. If you can't find the form you need, call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact us. If you need help completing a form, please contact us and we will help you.

NOTE

If you already have Medicare Part A and wish to sign up for Medicare Part B, please call 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office. You cannot sign up online for Medicare Part B only.


Number Title Topic
Online Apply for retirement, spouse's or Medicare benefits Online Forms
Online Apply for disability benefits Online Forms
Online Adult Disability Report Online Forms
Online Child Disability Report Online Forms
Online Appeal a recent medical decision Online Forms
Online Apply Online for Extra Help with Medicare Prescription Drug Plan Costs Online Forms
Online Get a replacement Medicare card Online Forms
Online Request a proof of Social Security benefits letter Online Forms
Online Request a form SSA-1099/1042 (Benefit Statement) for tax or other purposes Online Forms
Online Sign up for or change direct deposit Online Forms
Online Change address or telephone number Online Forms
Online Request special notices for the blind or visually impaired Online Forms
Online Representative Payee Accounting Report Online Forms
SSA-44 Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event Medicare
SSA-1020-OCR-SM-INST General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs Medicare
SSA-1020-OCR-SM General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs Medicare
SSA-1020-OCR-SM-SP Instrucciones generales para llenar la Solicitud para el Benefi cio Adicional con los gastos del plan de medicamentos recetados de Medicare Medicare
SSA-1020B-OCR-SM-INST General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs Medicare
SSA-1020B-OCR-SM-INST-SP Instrucciones generales para llenar la Solicitud para el Benefi cio Adicional con los gastos del plan de medicamentos recetados de Medicare Medicare
SSA-1020B-OCR-SM General Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs Medicare
SSA-1020B-OCR-SM-SP Instrucciones generales para llenar la Solicitud para el Benefi cio Adicional con los gastos del plan de medicamentos recetados de Medicare Medicare
SSA-1021 Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs Medicare
SSA-1021-INST Instructions for Completing the Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs Medicare
SSA-1021-SP Apelación de la determinación para recibir el Beneficio Adicional con los gastos del plan de medicamentos recetados de Medicare Medicare
SSA-1021-INST-SP Instrucciones para llenar la apelación de la determinación para recibir el beneficio adicional con los gastos del plan de medicamentos recetados de Medicare Medicare
SSA-1026B-INST Review Of Your Eligibility For Extra Help Medicare
SSA-1026B-INST-SP Revisión sobre su derecho a recibir el Beneficio Adicional Medicare
SSA-16-BK Application for Disability Insurance Benefits Disability
SSA-16-BK-SP Solicitud para beneficios de seguro por incapacidad Disability
SSA-16-INST Reporting Responsibilities For Disability Insurance Benefits Disability
SSA-827 Authorization to Disclose Information to the Social Security Administration Disability
SSA-827-INST-SP Instrucciones para completar el formulario SSA-827 Disability
SSA-199 Vocational Rehabilitation Provider Claim Disability
SSA-545 Plan for Achieving Self-Support Disability
SSA-546 Worker's Compensation/Public Disability Questionnaire Disability
SSA-820 Work Activity Report (Self-Employed Person) Disability
SSA-821 Work Activity Report Disability
SSA-3368 Disability Report - Adult Disability
SSA-3369 Work History Report Disability
SSA-3373-BK Function Report - Adult Disability
SSA-3375-BK Function Report - Child Birth to 1st Birthday Disability
SSA-3380 Function Report - Adult - Third Party Form Disability
SSA-3381 Medical and Job Worksheet Adult Disability
SSA-3820 Disability Report - Child Disability
SSA-3881 Questionnaire for Children Claiming SSI Benefits Disability
SSA-5665 Teacher Questionnaire Disability
SSA-561 Request for Reconsideration Reconsideration and Appeals
SSA-789 Request for Reconsideration - Disability Cessation Reconsideration and Appeals
SSA-3441 Disability Report - Appeal Reconsideration and Appeals
HA-501 Request for Hearing by Administrative Law Judge Reconsideration and Appeals
HA-520 Request for Review of Decision/Order of Administrative Law Judge Reconsideration and Appeals
HA-539 Notice Regarding Substitution of Party Upon Death of Claimant Reconsideration and Appeals
HA-4608 Waiver of Your Right to Personal Appearance Before an Administrative Law Judge Reconsideration and Appeals
HA-4631 Claimant's Recent Medical Treatment Reconsideration and Appeals
HA-4632 Claimant's Medications Reconsideration and Appeals
HA-4633 Claimant's Work Background Reconsideration and Appeals
SSA-1-BK Application for Retirement Insurance Benefits Benefit Application Supporting Forms
SSA-2-BK Application for Wife's or Husband's insurance benefits Benefit Application Supporting Forms
SSA-3 Marriage Certification Benefit Application Supporting Forms
SSA-21 Supplement to Claim of Person Outside the United States Benefit Application Supporting Forms
SSA-24 Application for Survivors Benefits (Payable Under Title II of the Social Security Act) Benefit Application Supporting Forms
SSA-25 Certification of Election for Reduced Spouse's Benefits Benefit Application Supporting Forms
SSA-150 Modified Benefits Formula Questionnaire Benefit Application Supporting Forms
SSA-308 Modified Benefits Formula Questionnaire, Foreign Pension Benefit Application Supporting Forms
SSA-437 Complaint Form for Allegations of Discrimination in Programs or Activities Conducted by the Social Security Administration Benefit Application Supporting Forms
SSA-437-BK-SP Formulario Para Querellas De Alegaciones De Discriminación En Los Programas De La Administración Del Seguro Social Benefit Application Supporting Forms
SSA-521 Request for Withdrawal of Application Benefit Application Supporting Forms
SSA-671 Railroad Employment Questionnaire Benefit Application Supporting Forms
SSA-781 Certificate of Responsibility for Welfare and Care of Child Benefit Application Supporting Forms
SSA-783 Statement Regarding Contributions Benefit Application Supporting Forms
SSA-795 Statement of Claimant or Other Persons Benefit Application Supporting Forms
SSA-1372 Advanced Notice of Termination of Child's Benefits Benefit Application Supporting Forms
SSA-1372-BK-FC Advanced Notice of Termination of Child's Benefits (Foreign Claims) Benefit Application Supporting Forms
SSA-2032 Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate Benefit Application Supporting Forms
SSA-2512 Pre-1957 Military Service Federal Benefit Questionnaire Benefit Application Supporting Forms
SSA-2519 Child Relationship Statement Benefit Application Supporting Forms
SSA-3885 Government Pension Questionnaire Benefit Application Supporting Forms
SSA-4111 Certification of Election for Reduced Widow(er)'s and Surviving Divorced Spouse's Benefits Benefit Application Supporting Forms
SSA-5666 Request for Administrative Information Benefit Application Supporting Forms
SSA-7008 Request for Correction of Earnings Record Benefit Application Supporting Forms
SSA-7104 Partnership Questionnaire Benefit Application Supporting Forms
SSA-7156 Farm Self Employment Questionnaire Benefit Application Supporting Forms
SSA-7157 Farm Arrangement Questionnaire Benefit Application Supporting Forms
SSA-7163 Questionnaire About Employment or Self Employment Benefit Application Supporting Forms
SSA-7163A Supplemental Statement Regarding Farming Activities Benefit Application Supporting Forms
SSA-4 Application for Child's Insurance Benefits Other Forms
SSA-4-INST Reporting Responsibilities for Child's Insurance Benefits Other Forms
SSA-5 Application for Mother's or Father's Insurance Benefits Other Forms
SSA-5-INST Reporting Responsibilities for Mother's or Father's Insurance Benefits Other Forms
SS-5 Application for a Social Security Card Other Forms
SS-5-FS Application for a Social Security Card (Outside of the U.S.) Other Forms
SS-5-SP Solicitud para una tarjeta de Seguro Social Other Forms
SSA-7 Application for Parent's Insurance Benefits Other Forms
SSA-8 Application for Lump-Sum Death Payment Other Forms
SSA-10 Application for Widow's or Widower's Insurance Benefits Other Forms
SSA-10-INST Reporting Responsibilities for Widow's or Widower's Insurance Benefits Other Forms
SSA-88 Pre-Approval Form for Consent Based Social Security Number Verification (CBSV) Other Forms
SSA-89 Authorization for the Social Security Administration To Release Social Security Number (SSN) Verification Other Forms
SSA-89-SP Autorización para que la Administración de Seguro Social Divulgue la Verificación de un Número de Seguro Social (SSN) Other Forms
SSA-117 How Are We Doing? Other Forms
SSA-131 Employer Report of Special Wage Payments Other Forms
SSA-632 Request for Waiver of Overpayment Recovery or Change in Repayment Rate Other Forms
SSA-L706 Letter to Custodian of Birth Records Other Forms
SSA-711 Request for Deceased Individual's Social Security Record Other Forms
SSA-714 You Can Make Your Payment By Credit Card Other Forms
SSA-721 Statement of Death by Funeral Director Other Forms
SSA-753 Statement Regarding Marriage Other Forms
SSA-754 Statement of Marital Relationship Other Forms
SSA-1383 Student Reporting Form Other Forms
SSA-1560 Petition to Obtain Approval of a Fee For Representing a Claimant Before the Social Security Administration Other Forms
SSA-1694 Request for Business Entity Taxpayer Information Other Forms
SSA-1695 Identifying Information for Possible Direct Payment of Authorized Fees Other Forms
SSA-1696 Appointment of Representative Other Forms
SSA-1699 Registration for Appointed Representative Services and Direct Payment Other Forms
SSA-1724 Claim For Amounts Due In Case Of A Deceased Beneficiary Other Forms
SSA-1945 Statement Concerning Your Employment In a Job Not Covered by Social Security Other Forms
SSA-2000 Application for Special Benefits for World War II Veterans Other Forms
SSA-3033 Retirement, Survivors and Disability Insurance Supplemental Security Income Other Forms
SSA-3105 Important information about your appeal, waiver rights, and repayment options Other Forms
SSA-3288 Consent for Release of Information Other Forms
SSA-3288-SP Consentimiento para divulgar información Other Forms
SSA-4162 Child Care Dropout Questionnaire Other Forms
SSA-L4201 Letter to Employer Requesting Wage Information Other Forms
SSA-7050 Request for Social Security Earnings Information Other Forms
SSA-8202 Statement for Determining Continuing Eligibility for Supplemental Security Income Payment Other Forms