Sections 205(c) and 702 of the Social Security Act, as amended, allow us to collect this information Furnishing us this information is voluntary However, failing to provide all or part of the information may prevent us from assigning you a Social Security number (SSN) and issuing you a new or replacement Social Security card
9 B ,10 B If you are applying for an original Social Security card for a child under age 18, you MUST show the parents' Social Security numbers unless the parent was never assigned a Social Security number If the number is not known and you cannot obtain it, check the “unknown” box
SOCIAL SECURITY ADMINISTRATION Application for a Social Security Card Page 1 Applying for a Social Security Card is free USE THIS APPLICATION TO: Apply for an original Social Security card Apply for a replacement Social Security card Change or correct information on your Social Security number record IMPORTANT:
9 B ,10 B If you are applying for an original Social Security card for a child under age 18, you MUST show the parents' Social Security numbers unless the parent was never assigned a Social Security number If the number is not known and you cannot obtain it, check the “unknown” box 13
PROTECT YOUR SOCIAL SECURITY NUMBER AND CARD Protect your SSN card and number from loss and identity theft DO NOT carry your SSN card with you Keep it in a secure location and only take it with you when you must show the card; e g , to obtain a new a Social Security card Form SS-5-FS (08-2011) ef (08-2011) ( ) - -
Application for a Social Security Card Applying for a Social Security Card is free USE THIS APPLICATION TO: Apply for an original Social Security card Apply for a replacement Social Security card Change or correct information on your Social Security number record IMPORTANT:
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