SSA-827 (with electronic signature(adult first person only)

Authorization to Disclose Information to the Social Security Administration

eAuthorization Screens for July 2013 release - childhood claims

SSA-827 (with electronic signature(adult first person only)

OMB: 0960-0623

Document [pdf]
Download: pdf | pdf
Figure 1. Initial screen for child claimant

Figure 2. Child claimant signing on own behalf

Figure 3. Child claimant signing on own behalf and less than 12 years old.

Figure 4. Third-party (who was already enter into EDCS) signing for child claimant

Figure 5. Third-party (adding new person) signing for child claimant


File Typeapplication/pdf
AuthorManisha Mehta
File Modified2013-05-03
File Created2013-05-03

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