Form Ssa-820-Bk - Work Activity Report - Self-Employment Page 2

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For More Information
Please read the enclosed pamphlet, “Working While Disabled ... How We Can Help.” It will tell you
more about why we need to know about your work, and will explain our rules about working. This
pamphlet is also available online at
If You Have Questions
If you have any questions, or need help completing the form:
Visit our website at
to find general information about Social Security.
Call us toll-free at 1-800-772-1213, or call your local office at
. You may also call
your Social Security contact,
, at
. We can answer most
questions over the phone.
Write or visit any Social Security office. If you plan to visit an office, you may call ahead to make
an appointment. The office that serves your area is located at:
If you are deaf or hard of hearing, our toll-free TTY number is 1-800-325-0778.
If you live outside the United States, please contact any Social Security office or the nearest
United States Embassy or consulate. If you live in the Philippines, you may contact the Veterans
Administration Regional Office, Social Security Division, 1131 Roxas Boulevard, Manila. You may
also write to the Social Security Administration, P.O. Box 17775, Baltimore, Maryland,
21235-7775, USA.
Please have this letter with you if you call or visit an office. If you write, please include a copy of this
letter. It will help us answer your questions.
Social Security Administration
Enclosures:
SSA Pub No. 05-10095
Pre-addressed Envelope
Form SSA-820-BK (04-2012) ef (04-2012)

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