SS-5 Form - Application for a Social Security Card - Sample

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SS-5 Form - Application for a Social Security Card/Account Number (SSN)

Here is a sample image of the Social Security Administration's SS-5 Form. These forms varied slightly over time.

Social Security Administration's SS-5 Form - Application for a Social Security Card - Sample
Click the image to see a larger version.
Image from the Social Security Administration


Here you can see the SS-5 form for actor Gregory Peck:
Gregory Peck in the Social Security Death Index and his SS-5 Form

Return to the Freedom of Information Act Page

Social Security Death Index - Online Searching

 

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