Application for a Social Security Card - Asking for Replacement Card beyond allowable limits (Paper or SSNAP Intranet Modalities)

SSNAP Screen Designs
Main Menu .................................................................................................................................. 2
Application Information – 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
Voluntary Race and Ethnicity Identification ...............................................................................9
Verify and Sign ........................................................................................................................... 8

SSNAP Screen Designs Page 1 of 9 – OMB
September 15, 2021

Main Menu

SSNAP Screen Designs Page 2 of 9 – OMB
September 15, 2021

Application Information Screen

SSNAP Screen Designs Page 3 of 9 – OMB
September 15, 2021

Numberholder Information Screen

SSNAP Screen Designs Page 4 of 9 – OMB
September 15, 2021

Numberholder Address
U.S. is Default Selection

Foreign Address Selected

Military Address Selected

SSNAP Screen Designs Page 5 of 9 – OMB
September 15, 2021

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

Non U.S. Citizen 12 or Older Interview Questions

SSNAP Screen Designs Page 6 of 9 – OMB
September 15, 2021

Additional Information

SSNAP Screen Designs Page 7 of 9 – OMB
September 15, 2021

Voluntary Race and Ethnicity Identification

SSNAP Screen Designs Page 8 of 9 – OMB
September 15, 2021

Verify and Sign

SSNAP Screen Designs Page 9 of 9 – OMB
September 15, 2021