Authorization for the Social Security Administration to Obtain Personal Information

SSA uses Form SSA-8510 to contact a public or private custodian of records on behalf of an applicant or recipient of an SSA program to request evidence information, which may support a benefit application or payment continuation. We ask for evidence information such as the following: • Age requirements (e.g. birth certificate, court documents) • Insured status (e.g. earnings, employer verification) • Marriage or divorce information • Pension offsets • Wages verification • Annuities • Property information • Benefit verification from a State agency or third party • Immigration status (rare instances) • Income verification from public agencies or private individuals • Unemployment benefits • Insurance policies If the custodian requires a signed authorization from the individual(s) whose information SSA requests, SSA may provide the custodian with a copy of the SSA-8510. Once the respondent completes the SSA-8510, either using the paper form, or using the Personal Information Authorization Intranet version, SSA uses the form as the authorization to obtain personal information regarding the respondent from third parties until the authorizing person (respondent) revokes the permission of its usage. The collection is voluntary; however, failure to verify the individuals’ eligibility can prevent SSA from making an accurate and timely decision for their benefits. The respondents are individuals who may file for, or currently receive, Social Security benefits, SSI payments, or Medicare Part D subsidies.

The latest form for Authorization for the Social Security Administration to Obtain Personal Information expires 2021-10-31 and can be found here.

SSA-8510 – Medicare Subsidy Quality Review (paper version)

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.