Current SSA-820-APP (submittable PDF)

SSA-820-APP Screen Package - Current Version.pdf

Work Activity Report (Self-Employment)

Current SSA-820-APP (submittable PDF)

OMB: 0960-0598

Document [pdf]
Download: pdf | pdf
SSA820 Online Application
Screen Package
June 25, 2021

SSA820 Screen Package

1

Contents
Application Landing Page: ................................................................................................................................................3
Email and Password Landing Page: ....................................................................................................................................4
Email Confirmation Page: ..................................................................................................................................................5
First Email: ........................................................................................................................................................................6
Password Confirmation: ..................................................................................................................................................7
SSA820 Cover Sheet: .......................................................................................................................................................8
SSA820 Adobe Form: .......................................................................................................................................................9
Attachment Fields: .........................................................................................................................................................15
Example of Conditional Required Fields: ......................................................................................................................16
Signature:.......................................................................................................................................................................17
Completed Signature:........................................................................................................................................................18
SSA Adobe Forms Completion Page: .....................................................................................................................................................................19
Final Email: .................................................................................................................................................................................................................20
Password Request Page:..........................................................................................................................................................................................21
SSA820 Completed Form:........................................................................................................................................................................................22

SSA820 Screen Package

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Application Landing Page:

SSA820 Screen Package

3

Email and Password Landing Page:

On this page, the claimant sets the password that will be used to access the form.

SSA820 Screen Package

4

Email Confirmation Page:

SSA820 Screen Package

5

First Email:

SSA820 Screen Package

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Password Confirmation:

The claimant must provide the password to access the form.

SSA820 Screen Package

7

SSA820 Cover Sheet:

SSA820 Screen Package

8

SSA820 Adobe Form:

Red asterisks notate a required field. Note that some required fields are conditional, based upon how the
prior question was answered. Please see page 16 for an example.

SSA820 Screen Package

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SSA820 Adobe Form:

SSA820 Screen Package

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SSA820 Adobe Form:

SSA820 Screen Package

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SSA820 Adobe Form:

SSA820 Screen Package

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SSA820 Adobe Form:

SSA820 Screen Package

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SSA820 Adobe Form:

SSA820 Screen Package

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Attachment Fields:

SSA820 Screen Package

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Example of Conditional Required Fields:

The SSA820's questions are based on conditional values. The example displayed above shows that by
selecting "YES" to question 1, question 2 is not available to enter information in, and the user can move
onto question 3.
SSA820 Screen Package

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Signature:

By clicking in the Signature field the user can type their name to sign the document.

SSA820 Screen Package

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Completed Signature:

Signature now appears on the form with the date it was signed appearing below signature. If all required fields
are filled out, user can "Click to Sign".

SSA820 Screen Package

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SSA820 Adobe Form Completion Page:

SSA820 Screen Package

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Final Email:

SSA820 Screen Package

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Password Request Page:

In order to view the completed form, the user must enter their pre-established password .

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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SSA820 Completed Form:

SSA820 Screen Package

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File Typeapplication/pdf
AuthorKao, Christopher Contractor
File Modified2021-08-10
File Created2021-01-21

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