SSA-827 (with electronic signature(adult first person only)

Authorization to Disclose Information to the Social Security Administration

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0623 can be found here:

Document [pdf]

Download: pdf | pdf

eView Blank (Telephone)

eView Blank (In Office)

eView – Yes

eView – No

eView – No (Decline Options)

eView – Decline

Case Data

File Type	application/pdf
File Title	Microsoft Word - PA Statement for SSA-827.doc
Author	177717
File Modified	2011-06-17
File Created	2011-06-17