Application for a Social Security Card

Appendix C: SSNAP Screen Designs

Main Menu 2

Applicant Info – Select Applicant 3

Numberholder Information 4

Numberholder Address 5

U.S. is Default Selection 5

Foreign Address Selected 5

Military Address Selected 5

12 or Older Interview Questions 6

U.S. Citizen 12 or Older Interview Questions 6

Non U.S. Citizen 12 or Older Interview Questions 6

Additional Information 7

Verify and Sign 8

Voluntary Race and Ethnicity Identification 9

Main Menu

Options in the left menu will depend on the user’s profile.

This is an example of selecting Retrieve Application from the Main Menu and entering data for a person who has never applied for a SSN. The user is then given the opportunity to create a new application.

Applicant Info – Select Applicant

The user is able to select the language of the attestation that is to be presented to the applicant. The corresponding attestation is presented on the screen. The US Mailing Zip Code is requested to ensure that the applicant is in the proper jurisdiction to best be served. SSA has Card Centers in major cities with their sole function to issue original and replacement SSNs.

This is the dropdown menu with the possible choices of a proper applicant.

Numberholder Information

Numberholder Address

U.S. is Default Selection

Foreign Address Selected

Military Address Selected

12 or Older Interview Questions

U.S. Citizen 12 or Older Interview Questions

Answers in this box to propagate to the printed application

Non U.S. Citizen 12 or Older Interview Questions

Answers in this box to propagate to the printed application

Additional Information

Verify and Sign

Voluntary Race and Ethnicity Identification

Updated Appendix C: SSNAP Screen Designs Page 9 of 9 – OMB

April 12, 2011