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Form SSA-5-BK (revised) SSA-5-BK (revised) Application for Mother's or Father's Insurance Benefits
Application for Mother's or Father's Insurance Benefits
SSA-5-BK (revised)
Application for Mother's of Father's Insurance Benefits / SSA-5-BK
OMB: 0960-0003
OMB.report
SSA
OMB 0960-0003
ICR 201902-0960-007
IC 8867
Form SSA-5-BK (revised) SSA-5-BK (revised) Application for Mother's or Father's Insurance Benefits
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0003 can be found here:
2021-06-25 - Revision of a currently approved collection
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File Type
application/pdf
File Title
P352B82-20180927111848
File Modified
2018-10-10
File Created
2018-09-27
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