Request for Internet Services - Authentication -- Special Notice Option

Request for Internet Services-Authentication; Automated Telephone Speech Technology-Authentication

Verification Screen

Request for Internet Services - Authentication -- Special Notice Option

OMB: 0960-0596

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VerifY Your Infonnation

Page 1 of 1

Social &uuity Online

Social Security Online Services 


http://www socialsecurity .govl

Verify Your 

Information 

Your full name:
John Smith
Other last name:
Your Social Security number: 743-12-1212
Your date of birth :
December 30,1979
If this information is correct, select "Confirm".
If this information is incorrect, select "Change
Your Information" to go back and correct it.

I Exit I

(

Change Your Information

) [ Confirm

mhtml:file:IIC:\Documents and Settings\413980\Local Settings\Temporary Internet Files\...

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File Typeapplication/pdf
File Modified2009-12-10
File Created2009-12-10

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