Form SSA-8060-U3 Agreement to Sell Property

Form SSA-8060 (10-2022)
Discontinue Prior Editions
Social Security Administration
Claim No.

Agreement to Sell Property
Individual

Description of Each Resource if Real
Property, Show Address or Location

Spouse

Names of Owners

Page 1 of 2
OMB No. 0960-0127
(DO NOT USE THIS SPACE)

Parent

Nature and Percentage
Ownership of Each

Estimated Net
Proceeds of Sale
Estimated Current Amount Owed on
(After Sales
Market Value
Resource, if Any
Expenses & Any
Amount Owed)

1.

2.

CONDITIONS OF AGREEMENT: My (our) resources exceed the amount which an eligible individual (or eligible individual and spouse) may have and still qualify for
payments under Title XVI of the Social Security Act. I (we) hereby request that conditional payments be made to me (us) until I (we) can sell the above-described
resources at their current market value. Once Social Security notifies me (us) that this agreement has been approved. I (we) agree to take all necessary and proper steps
to sell the above described resources and to actively continue my (our) efforts to do so until the resources are sold. I (we) agree to sell the above-described resources for
the highest price I (we) can get and to do so within 9 months (3 months) of being notified that the agreement is approved. I (we) also agree to notify the Social Security
Administration within 5 working days after I (we) complete the sale. I (we) further agree to repay immediately all payments I (we) have received that would not have been
paid if I (we) had sold the above-described resources the day I (we) filed application for benefits. I (we) further understand that if I (we) fail to comply with the terms of this
agreement, I (we) will be required to make immediate refund of all payments made. (Read the information on the back of this form.)
I declare under penalty of perjury that I have examined all the information on this form, and on any accompanying statements or forms, and it is true and
correct to the best of my knowledge.
Signature

Address (Street and No.)

City, State, and ZIP Code

Date

Signature

Address (Street and No.)

City, State, and ZIP Code

Date

Signature

Address (Street and No.)

City, State, and ZIP Code

Date

Form SSA-8060 (10-2022)

Page 2 of 2
IMPORTANT INFORMATION ABOUT THIS AGREEMENT

1. TIME LIMITS FOR SELLING PROPERTY
The time limit during which you must sell the property is:
Real Property (Houses, Land, etc.) - 9 months from the date this agreement is approved
All Other Property - 3 months from the date this agreement is approved.
Notify your Social Security office immediately if you find you are unable to sell the property within this time limit.
2. CURRENT MARKET VALUE
When you sign the other side of this form, you agree to sell the resources described there for their current market value. This
means the highest amount you can get by offering it on the open market. If you knowingly dispose of an agreed-upon resource
for less than its current market value, the Social Security Administration will determine what the current market value was at
the time of disposition and determine the amount of your overpayment accordingly.
3. NOTIFYING YOUR SOCIAL SECURITY OFFICE
Notify your Social Security office as soon as you sell the property. Also notify your Social Security office immediately if you
encounter difficulty in selling the property or if you decide not to sell the property.

Privacy Act Statement
See Revised
Collection and Use of Personal Information Privacy Act
Section 1613(b) of the Social Security Act, as amended, allows us to collect this information. Furnishing
us this information is
Statement
voluntary. However, failing to provide all or part of the information may prevent an accurate and timely decision on any claim filed
and could result in the loss of some benefits.
We will use the information to make a determination of eligibility for benefits. We may also share your information for the following
purposes, called routine uses:
• To State agencies to enable them to assist in the effective and efficient administration of the Supplemental Security
Income program; and
• To contractors and other Federal agencies, as necessary, for the purpose of assisting the Social Security Administration
in the efficient administration of its programs.
In addition, we may share this information in accordance with the Privacy Act and other Federal laws. For example, where
authorized, we may use and disclose this information in computer matching programs, in which our records are compared with
other records to establish or verify a person's eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notice (SORN) 60-0103, entitled Supplemental
Security Income Record and Special Veterans Benefits, as published in the Federal Register (FR) on January 11, 2006, at 71 FR
1830. Additional information, and a full listing of all of our SORNs, is available on our website at www.ssa.gov/privacy.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as
amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless
we display a valid Office of Management and Budget control number. We estimate that it will take about 20 minutes
to read the instructions, gather the facts, and answer the questions. SEND OR BRING THE COMPLETED FORM
TO YOUR LOCAL SOCIAL SECURITY OFFICE. You can find your local Social Security office through SSA's
website at www.socialsecurity.gov. Offices are also listed under U. S. Government agencies in your
telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). You may send
comments regarding this burden estimate or any other aspect of this collection, including suggestions for reducing
this burden to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401. Send only comments relating to our time
estimate to this address, not the completed form.