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Form SSA-4-BK (Moderniz SSA-4-BK (Moderniz Application for Child's Insurance Benefits
Application for Child's Insurance Benefits
ssa-4 MCS Screens
Application for Child's Insurance Benefits / Life Claim / MCS / Signature Proxy
OMB: 0960-0010
OMB.report
SSA
OMB 0960-0010
ICR 200703-0960-003
IC 45024
Form SSA-4-BK (Moderniz SSA-4-BK (Moderniz Application for Child's Insurance Benefits
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0010 can be found here:
2022-10-24 - Revision of a currently approved collection
2019-09-20 - Revision of a currently approved collection
Document [pdf]
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pdf
File Type
application/pdf
Subject
ssa-4
Author
PETER
File Modified
0000-00-00
File Created
2007-03-22
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