SS-5 Application for a Social Security Card

SOCIAL SECURITY ADMINISTRATION
Application for a Social Security Card
Applying for a Social Security Card is free!
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 www.socialsecurity.gov.
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 www.socialsecurity.gov 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.

EVIDENCE DOCUMENTS
The following lists are examples of the types of documents you must provide with your application and are not
all inclusive. Call us at 1-800-772-1213 if you cannot provide these documents.
IMPORTANT: If you are completing this application on behalf of someone else, you must provide evidence
that shows your authority to sign the application as well as documents to prove your identity and the identity of
the person for whom you are filing the 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.
Evidence of Age
In general, you must provide your birth certificate. In some situations, we may accept another document that
shows your age. Some of the other documents we may accept are:
 U.S. Hospital record of your birth (created at the time of birth)
 Religious record established before age five showing your age or date of birth
 Passport
 Final Adoption Decree (the adoption decree must show that the birth information was taken from the
original birth certificate)
Evidence of Identity
You must provide current, unexpired evidence of identity in your legal name. Your legal name will be shown
on the Social Security card. Generally, we prefer to see documents issued in the U.S. Documents you submit
to establish identity must show your legal name AND provide biographical information (your date of birth, age,
or parents’ names) and/or physical information (photograph, or physical description – height, eye and hair
color, etc.). If you send a photo identity document but do not appear in person, the document must show your
biographical information (e.g., your date of birth, age, or parents’ names). Generally, documents without an
expiration date should have been issued within the past two years for adults and within the past four years for
children.
As proof of your identity, you must provide a:
 U.S. drivers’ license; or
 U.S. State-issued non-driver identity card; or
 U.S. passport
If you do not have one of the documents above or cannot get a replacement within 10 work days, we may
accept other documents that show your legal name and biographical information, such as a U.S. military
identity card, Certificate of Naturalization, or employee identity card, certified copy of medical record (clinic,
doctor or hospital), health insurance card, Medicaid card or school identity card/record. For young children, we
may accept medical records (clinic, doctor, or hospital) maintained by the medical provider. We may also
accept a final adoption decree, or a school identity card or other school record maintained by the school.
If you are not a U.S. citizen, we must see your current U.S. immigration document(s) and your foreign passport
with biographical information or photograph.
WE CANNOT ACCEPT A BIRTH CERTIFICATE, HOSPITAL SOUVENIR BIRTH CERTIFICATE, SOCIAL
SECURITY CARD STUB, OR A SOCIAL SECURITY RECORD as evidence of identity.
Evidence of U.S. Citizenship
In general, you must provide your U.S. birth certificate or U.S. Passport. Other documents you may provide are
a Consular Report of Birth, Certificate of Citizenship, or Certificate of Naturalization.
Evidence of Immigration Status
You must provide a current unexpired document issued to you by the Department of Homeland Security (DHS)
showing your immigration status, such as Form I-551, I-94, I-688B, or I-766. If you are an international student
or exchange visitor, you may need to provide additional documents, such as Form I-20, DS-2019, or a letter
authorizing employment from your school and employer (F-1) or sponsor (J-1). We CANNOT accept a receipt
showing you applied for the document. If you are not authorized to work in the U.S., we can issue you a Social
Security card only if you need the number for a valid non-work reason. Your card will be marked to show you
cannot work and if you do work, we will notify DHS. See page 3, item 5 for more information.

HOW TO COMPLETE THIS APPLICATION
Complete and sign this application LEGIBLY using ONLY black or blue ink on the attached or
downloaded form using only 8 ½” x11” (or A4 8.25” x 11.7”) paper.
GENERAL: Items on the form are self-explanatory or are discussed below. The numbers match the
numbered items on the form. If you are completing this form for someone else, please complete the
items as they apply to that person.
4. Show the month, day, and full (4 digit) year of birth, for example, “1998” for year of birth.
5. If you check “Legal Alien Not Allowed to Work” or “Other” you must provide a document from a
U.S. Federal, State, or local government agency that explains why you need a Social Security
number and that you meet all the requirements for the government benefit. NOTE: Most agencies do
not require that you have a Social Security number. Contact us to see if your reason qualifies for a
Social Security number.
6. Providing race/ethnicity information is voluntary and is requested for informational and statistical
purposes only. Your choice whether to answer or not does not affect decisions we make on your
application. If you do provide this information, we will treat it very carefully.
8.B, 9.B. If you are applying for an original Social Security Card for a child under age 18, you MUST
show the mother’s and father’s Social Security numbers unless the mother and/or father was never
assigned a Social Security number. If the number is not known and you cannot obtain it, check the
“unknown” box. Do not complete for replacement cards unless you are changing the number(s)
currently shown on your record.
12. If the date of birth you show in item 4 is different from the date of birth currently shown on your
Social Security record, show the date of birth currently shown on your record in item 12 and provide
evidence to support the date of birth shown in item 4.
15. Show an address where you can receive your card 7 to 14 days from now.
16. WHO CAN SIGN THE APPLICATION? If you are age 18 or older and are physically and
mentally capable of reading and completing the application, you must sign in item 16. If you are
under age 18, you may either sign yourself, or a parent or legal guardian may sign for you. If you are
over age 18 and cannot sign on your own behalf, a legal guardian, parent, or close relative may
generally sign for you. If you cannot sign your name, you should sign with an ‘X” mark and have two
people sign as witnesses in the space beside the mark. Please do not alter your signature by
including additional information on the signature line as this may invalidate your application. Call us if
you have questions about who may sign your application.
HOW TO SUBMIT THIS APPLICATION
In most cases, you can take or mail this signed application with your documents to any Social
Security office. Any documents you mail to us will be returned to you. If you live in an area serviced
by a Social Security Card Center, you must visit the Social Security Card Center in person for all
Social Security related business. Go to https://secure.ssa.gov/apps6z/FOLO/fo001.jsp to find the
Social Security office or Social Security Card Center that serves your area.

PROTECT YOUR SOCIAL SECURITY NUMBER AND CARD
Protect your SSN card and number from loss and identity theft. DO NOT carry your SSN card with you. Keep
it in a secure location and only take it with you when you must show the card, e.g., to obtain a new job, open a
new bank account, or to obtain benefits from certain U.S. agencies. Use caution in giving out your Social
Security number to others, particularly during phone, mail, email and Internet requests you did not initiate.
THE PAPERWORK/PRIVACY ACT AND YOUR APPLICATION
The Privacy Act of 1974 requires us to give each person the following notice when applying for a Social
Security number. Sections 205(c) and 702 of the Social Security Act allow us to collect the facts we ask for on
this form.
We use the facts you provide on this form to assign you a Social Security number and to issue you a Social
Security card. You do not have to give us these facts; however, without them we cannot issue you a Social
Security number or a card. Without a number, you may not be able to get a job and could lose Social Security
benefits in the future. The Social Security number is also used by the Internal Revenue Service for tax
administration purposes as an identifier in processing tax returns of persons who have income which is
reported to the Internal Revenue Service and by persons who are claimed as dependents on someone’s
Federal income tax return.
We ask for your race and ethnicity information as a result of an Office of Management and Budget directive for
Federal agencies to collect race and ethnicity information using standards consistent throughout the Federal
Government. The information we will collect will be used for statistical research purposes and will not be used
in any way to make a determination about the business you are conducting with Social Security. If you provide
this information, we will treat it very carefully.
We may disclose information as necessary to administer Social Security programs, including to appropriate law
enforcement agencies to investigate alleged violations of Social Security law; to other government agencies for
administering entitlement, health, and welfare programs such as Medicaid, Medicare, veterans’ benefits,
military pension, and civil service annuities, black lung, housing, student loans railroad retirement benefits, and
food stamps; to the Internal Revenue Service for Federal tax administration; and to employers and former
employers to properly prepare wage reports. We may also disclose information as required by Federal law, for
example, to the Department of Homeland Security, to identify and locate aliens in the U.S., to the Selective
Service System for draft registration; and to the Department of Health and Human Services for child support
enforcement purposes. We may verify Social Security numbers for State motor vehicle agencies that use the
number in issuing drivers’ licenses, as authorized by the Social Security Act. Finally, we may disclose
information to your Congressional representative if he or she requests information to answer questions you ask
him or her.
We may disclose your race and ethnicity information when there are safeguards that the record will be used
solely as a statistical or research record and your information cannot be identified from any information in the
record, or to facilitate statistical research and audit activities necessary to assure the integrity and improvement
of the Social Security programs (e.g., to the Bureau of the Census and private concerns under contract to
Social Security).
We may use the information you give us when we match records by computer. Matching programs compare
our records with those of other Federal, State, or local government agencies to determine whether a person
qualifies for benefits paid by the Federal government. The law allows us to do this even if you do not agree.
Explanations about these and other reasons why information you provide us may be used or given out are
available in Social Security offices. If you want to learn more about this, contact any Social Security office.
This information collection meets the requirements of 44 U.S.C. §3507, as amended by Section 2 of the
Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid office
of Management and Budget control number. We estimate that it will take about 8.5 to 9.5 minutes to read the
instructions, gather the facts, and answer the questions. You may send comments on our time estimate to:
SSA, 6401 Security Blvd., Baltimore, MD 21235-6401. Send only comments relating to our time estimate
to this address, not the completed form.