Statement of Claimant or Other Person (Paper /in-office interview)

Statement of Claimant or Other Person

OMB: 0960-0045

IC ID: 43690

Documents and Forms

Document Name Document Type
Form SSA-795 Statement of Claimant or Other Person (Paper /in-office interview) Form
SSA-795 Statement of Claimant or Other Person SSA-795.pdf Form
SSA-795 - CCE Screen package.pdf Other-SSI Claim System Remarks Screen