SSA-8001-BK - Additional MSSICS Screen for Financial Permissions

SSA-8001-BK - New MSSICS Screen.doc

Application for Supplemental Security Income

SSA-8001-BK - Additional MSSICS Screen for Financial Permissions

OMB: 0960-0444

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MSSICS                              FINANCIAL INSTITUTIONS PERMISSION               AFIP

                                                                          

 999-99-9999    SSSSS SSSSSSSSSS                                           TRANSFER TO: XXXX

 

 PERMISSION TO CONTACT FINANCIAL INSTITUTIONS (Y/N): X

   

    IF NO, GOOD CAUSE ESTABLISHED (Y/N): X

 

 PERMISSION AND / OR GOOD CAUSE CHANGED, DATE (MMDDYY): 999999

 

 INELIGIBILITY NOTICE DATE (mmddyy): 999999

                                                     

 PERMISSION STATUS CHANGE (y): x                                 REMARKS (Y): X

File Typeapplication/msword
File TitleMSSICS FINANCIAL INSTITUTIONS PERMISSION AFIP
Author177717
Last Modified By177717
File Modified2009-09-17
File Created2009-09-17

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