Form SS-5

Form SS-5, officially titled the Application for a Social Security Card, is the form you must use to apply for an original Social Security card, request a replacement, or update/correct information on your Social Security number record. This form is issued by the Social Security Administration (SSA) and is required for U.S. citizens, lawful immigrants, and other eligible individuals who need a Social Security number (SSN) for employment, government benefits, or other official purposes. The process is free, but you must provide original or certified documents to prove your age, identity, citizenship, or immigration status. The SSA uses the information you provide to assign or update your SSN, issue a card, and ensure your information is accurate for Social Security benefits and other federal programs. It’s important to fill out the form accurately and legibly, following all requirements, and to submit the necessary supporting documents as specified by the SSA.

How to File Form SS-5?

1. Obtain the Form: Download Form SS-5 from the SSA website or visit your local Social Security office to pick up a copy.
2. Gather Required Documents: Collect original or certified documents to prove your age, identity, and citizenship or immigration status. Photocopies or notarized copies are not accepted.
3. Complete the Form: Fill out the application legibly using black or blue ink.
4. Submit the Application: Mail or take the completed form and your documents to your nearest Social Security office or Card Center. All documents will be returned to you.
5. Wait for Processing: Your new or replacement Social Security card will be mailed to the address you provide, typically within 7–14 days.

How to Complete Form SS-5?

NAME TO BE SHOWN ON CARD

• First, Full Middle Name, Last: Enter your full legal name as you want it to appear on your Social Security card.

1. FULL NAME AT BIRTH IF OTHER THAN ABOVE

• First, Full Middle Name, Last: If your name at birth differs from your current legal name, enter it here.

2. OTHER NAMES USED

• List any other names you have used (aliases, maiden names, previous married names, etc.).

3. SOCIAL SECURITY NUMBER PREVIOUSLY ASSIGNED TO THE PERSON LISTED IN ITEM 1

• Enter your previous SSN if you have one. If not, leave blank.

4. PLACE OF BIRTH (Do Not Abbreviate)

• City, State or Foreign Country: Write the full name of your birth city and state or country (no abbreviations).

5. CITIZENSHIP (Check One)

• Check the appropriate box:
  • U.S. Citizen
  • Legal Alien Allowed to Work
  • Legal Alien Not Allowed to Work (see instructions for required documentation)
  • Other (see instructions for required documentation)

6. ETHNICITY (Your Response is Voluntary)

• Indicate if you are Hispanic or Latino by checking “Yes” or “No.”

7. RACE (Select One or More, Your Response is Voluntary)

• Check all boxes that apply:
  • Native Hawaiian
  • Alaska Native
  • Asian
  • American Indian
  • Black/African American
  • Other Pacific Islander
  • White

8. SEX

• Check “Male” or “Female.”

9. DATE OF BIRTH (MM/DD/YYYY)

• Enter your full date of birth in month/day/year format.

10. A. PARENT/MOTHER’S NAME AT HER BIRTH (First, Full Middle Name, Last)

• Enter your mother’s name at her birth.

10. B. PARENT/MOTHER’S SOCIAL SECURITY NUMBER

• Enter your mother’s SSN if known. If not known, check “Unknown.”

11. A. PARENT/FATHER’S NAME (First, Full Middle Name, Last)

• Enter your father’s full name.

11. B. PARENT/FATHER’S SOCIAL SECURITY NUMBER

• Enter your father’s SSN if known. If not known, check “Unknown.”

12. HAS THE PERSON LISTED IN ITEM 1 OR ANYONE ACTING ON HIS/HER BEHALF EVER FILED FOR OR RECEIVED A SOCIAL SECURITY NUMBER CARD BEFORE?

• Check “Yes,” “No,” or “Don’t Know.”
  • If “Yes,” proceed to questions 13 and 14.
  • If “No” or “Don’t Know,” skip to question 15.

13. NAME SHOWN ON THE MOST RECENT SOCIAL SECURITY CARD ISSUED FOR THE PERSON LISTED IN ITEM 1

• If you answered “Yes” to #12, enter the name as it appeared on the most recent card.

14. ENTER ANY DIFFERENT DATE OF BIRTH IF USED ON AN EARLIER APPLICATION FOR A CARD

• If applicable, enter any different birth date used previously.

15. TODAY’S DATE (MM/DD/YYYY)

• Enter the date you are completing the form.

16. DAYTIME PHONE NUMBER

• Enter your area code and phone number where you can be reached during the day.

17. MAILING ADDRESS

• Street Address, Apt. No., PO Box, Rural Route No., City, State/Foreign Country, ZIP Code: Enter the address where you want your Social Security card mailed. Do not abbreviate city or state.

18. I DECLARE UNDER PENALTY OF PERJURY…

• YOUR SIGNATURE: Sign your full legal name.
• YOUR RELATIONSHIP TO THE PERSON IN ITEM 1 IS: Check the appropriate box (Self, Natural or Adoptive Parent, Legal Guardian, Other-specify).

Additional Notes

• Who Can Sign: If you are 18 or older and capable, you must sign. For minors, a parent or legal guardian can sign. If you cannot sign, use an “X” and have two witnesses sign beside your mark.
• Evidence: Always submit original or certified documents as proof for all required fields.
• Submission: Mail or bring your application and documents to your local Social Security office. Find your nearest office at www.socialsecurity.gov or call 1-800-772-1213.