How to Fill Out Form SSA-2853-OP4

Form SSA-2853-OP4 at a glance

What it is: Message from Social Security: information about when you will receive your baby's Social Security card.

Who signs: The form has lines for the Signature of hospital official and the Date.

A filled-in Form SSA-2853-OP4 example: a hospital completes the form for a newborn

Form SSA-2853-OP4 example filled out, example: a hospital completes the form for a newborn
A hospital official completes Form SSA-2853-OP4 for a newborn. The baby is named Jane Sample, so a Social Security number can be requested before the hospital stay ends. The picture shows the name filled in, and every value in it is made up. Nothing goes in Signature of hospital official and Date because the official adds them by hand.

How to fill out Form SSA-2853-OP4, box by box

Name of Child

Form SSA-2853-OP4 example filled out, name of Child

The form certifies that a Social Security number was requested for the child under Name of Child.

If you have not named your baby, Social Security cannot issue a Social Security card.

Signature of hospital official and Date

Form SSA-2853-OP4 example filled out, signature of hospital official and Date

The form has lines for the Signature of hospital official and the Date.

More rules for Form SSA-2853-OP4

It takes your State about 9 weeks to notify the Social Security Administration (SSA) about your baby's birth. The card will be mailed to you about one week after SSA is notified by the State of your baby's birth.

If you are filing for Welfare or other public assistance benefits for your baby, you will need the following information completed before you leave the hospital.

Notify your caseworker when you receive your baby's card.

Common questions about Form SSA-2853-OP4

How long does it take to get a new Social Security card?

You should get your baby's Social Security card in about 10 weeks.

Are there fees?

Never pay a fee to get a Social Security card. If anyone asks for money to help you get a card, notify SSA immediately at 1-800-772-1213.

Is there a penalty?

Anyone who knowingly gives a false statement about a material fact in this information, or causes someone else to do so, commits a crime and may be sent to prison, or may face other penalties, or both.

Sources

[1] Form SSA-2853-OP4 (08-2021), Social Security Administration (the Official source link on this page).

Form SSA-2853-OP4 PDF Details

The journey of welcoming a new member into the family is filled with numerous responsibilities, one of which involves ensuring they are recognized as citizens with rights and future opportunities. Among the key steps for this recognition in the United States is acquiring a Social Security card for your newborn, facilitated by the SSA 2853 form, an essential document from the Social Security Administration. This form serves a critical function by informing new parents about the process and timeline for receiving their baby's Social Security card, a process that typically spans about three weeks from the moment the state notifies the SSA of the baby's birth. It underscores the importance of naming your baby as a prerequisite for the Social Security card issuance and highlights the need for vigilance against fraudulent requests for payment in exchange for the card. Moreover, the form offers guidance for parents whose baby might have medical issues, advising them on how to inquire about eligibility for Supplemental Security Income (SSI). It also provides necessary information for parents receiving Social Security benefits themselves or those applying for welfare or other public assistance benefits on behalf of their newborn. The form encompasses a certification part that needs to be completed before leaving the hospital, ensuring a Social Security number request is on record. Through this document, the Social Security Administration communicates vital instructions and cautions, ensuring parents understand the steps, their rights, and the protections available for their newborn's social identity and future benefits.

QuestionAnswer
Form NameForm SSA-2853-OP4
Form Length1 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out27 sec
Other namesform ssa 2853 op3, ssa 2853 op1, ssa 2853 op3 form, ssa 2853 pdf