SSA Form SSA-795, also known as the “Statement of Claimant or Other Person,” is a document used by the Social Security Administration (SSA) to gather additional information from Social Security claimants or other individuals who have relevant information about a claim. This form allows individuals to provide the SSA with clear and specific details regarding various aspects of their claims, such as income, work history, or eligibility for benefits. It serves as a versatile tool to clarify or supplement information that cannot be fully captured through standard SSA forms.
The form is particularly useful when there is a need to correct or update information that may affect the claimant’s benefit entitlement or payment amount. For example, it can be used to explain discrepancies in employment records, report changes in income, or provide additional evidence required for the approval of disability benefits. SSA Form SSA-795 is also commonly employed to ensure that all relevant data is accurately considered in the decision-making process, helping to streamline the review and approval of benefits claims.
Other SSA Forms
You will discover even more fillable SSA forms accessible with our editor. Down below, we selected a number of the more popular forms included in this category. Moreover, do not forget that you are able to upload, fill out, and edit any PDF at FormsPal.
To fill out the document, we recommend you use our form-building software, as well as use our illustrated instructions below.
Identify the Claimant
You must indicate the name and SSN of the person affected by this document and whose case is being considered. It can be either yourself or another person.
Identify Yourself
If you are filling out the document not concerning yourself, then write in these lines your name, as well as the degree of your relationship with the Claimant (relative, spouse, friend, neighbor, colleague, and so on).
Draft the Statement
At this point, you need to give the statement itself. We recommend that you refer to the advice we have provided above for a successful application. Remember to keep it short and clear. It is recommended to abandon evaluative characteristics and to state only the facts.
Provide the Signature
With your signature, you certify your testimony and declare that all your testimony was given honestly. Otherwise, penalties and fines are assumed.
Put the Date and Provide Contact Information
After you set the date of filling out the form, provide your contact details:
Provide Witnesses
Witnesses do not always have to certify this form. They are necessary only if there is a corresponding mark put by the Administration representative. If there is such a mark, then two witnesses must sign the statement and provide their addresses.
Mail the Completed Document
Next, the document must be sent to the SSA office.
