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The purpose of this form is to assist you in filing a complaint with the Social Security Administration (SSA)

ICR 200701-0960-009 · OMB 0960-0585 · Object 1547101.

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The purpose of this form is to assist you in filing a complaint with the Social Security Administration (SSA)
ehoughton
Writer
2007-03-19
2026-10-26
complete