Fillable Application For A Social Security Card printable pdf download

SOCIAL SECURITY ADMINISTRATION

Application for a Social Security Card

free!

Applying for a Social Security Card is

USE THIS APPLICATION TO:

●

Apply for an original Social Security card

●

Apply for a replacement Social Security card

●

Change or correct information on your Social Security number record

IMPORTANT: You MUST provide a properly completed application and the required evidence before we

can process your application. We can only accept original documents or documents certified by the

custodian of the original record. Notarized copies or photocopies which have not been certified by the

custodian of the record are not acceptable. We will return any documents submitted with your application.

For assistance call us at 1-800-772-1213 or visit our website at

Original Social Security Card

To apply for an original card, you must provide at least two documents to prove age, identity, and U.S.

citizenship or current lawful, work-authorized immigration status. If you are not a U.S. citizen and do not

have DHS work authorization, you must prove that you have a valid non-work reason for requesting a

card. See page 2 for an explanation of acceptable documents.

NOTE: If you are age 12 or older and have never received a Social Security number, you must apply in

person.

Replacement Social Security Card

To apply for a replacement card, you must provide one document to prove your identity. If you were born

outside the U.S., you must also provide documents to prove your U.S. citizenship or current, lawful, work-

authorized status. See page 2 for an explanation of acceptable documents.

Changing Information on Your Social Security Record

To change the information on your Social Security number record (i.e., a name or citizenship change, or

corrected date of birth) you must provide documents to prove your identity, support the requested change,

and establish the reason for the change. For example, you may provide a birth certificate to show your

correct date of birth. A document supporting a name change must be recent and identify you by both your

old and new names. If the name change event occurred over two years ago or if the name change

document does not have enough information to prove your identity, you must also provide documents to

prove your identity in your prior name and/or in some cases your new legal name. If you were born outside

the U.S. you must provide a document to prove your U.S. citizenship or current lawful, work-authorized

status. See page 2 for an explanation of acceptable documents.

LIMITS ON REPLACEMENT SOCIAL SECURITY CARDS

Public Law 108-458 limits the number of replacement Social Security cards you may receive to 3 per

calendar year and 10 in a lifetime. Cards issued to reflect changes to your legal name or changes to a work

authorization legend do not count toward these limits. We may also grant exceptions to these limits if you

provide evidence from an official source to establish that a Social Security card is required.

IF YOU HAVE ANY QUESTIONS

If you have any questions about this form or about the evidence documents you must provide, please visit

our website at

for additional information as well as locations of our offices and

Social Security Card Centers. You may also call Social Security at 1-800-772-1213. You can also find

your nearest office or Card Center in your local phone book.

Form SS-5 (08-2011) ef (08-2011) Destroy Prior Editions

Page 1

Application For A Social Security Card

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