Certification of Contents of Document(s) or Record(s)

OMB 0960-0689

OMB 0960-0689

When individuals applying for Social Security benefits or SSI payments cannot provide documentation to substantiate their information, SSA uses the information on Form SSA-704 to establish proof of age, relationship, citizenship, marriage, death, military service, or to evaluate a family bible or other family record. SSA sends Form SSA-704 to State record custodians and other custodians of evidentiary documents, and, at our request, the custodians complete the form, supplying and verifying an applicant’s information against the original documents or records under their purview. We use this form in situations where the applicant cannot produce the evidentiary documentation required to establish eligibility. The respondents are State record custodians and other custodians of evidentiary documents.

The latest form for Certification of Contents of Document(s) or Record(s) expires 2022-09-30 and can be found here.


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