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Fillable Form SS-5 Replacement of Social Security Card

The form is used to apply for a new or replacement Social Security card that shows an individual's Social Security Number (SSN).


What is Form SS-5?

Form SS-5 is a legal form from the Social Security Administration (SSA) that U.S. citizens and foreign nationals holding a permanent or temporary residence and work permit use to apply for a new or replacement Social Security card.

On your Social Security card is your Social Security Number (SSN), which you will use for legal transactions, from getting Social Security benefits to opening a bank account, getting a job, and receiving medical treatment.

There are specific situations that require an individual to complete Form SS-5. If you fall under one of the following conditions, you must fill out and submit the form to get a Social Security card:

  • You are an adult and have never received a Social Security card
  • You need to replace a lost, stolen, or heavily damaged, beyond repair Social Security card
  • You need to make changes to an existing card due to marriage or divorce or a change in your name under a court order, as well as a clerical error, such as a misspelling of your name or an incorrect birth date
  • Your citizenship status has changed from being a legal foreign resident or green card holder to a U.S. citizen
  • You want to apply for your child or adopted child’s Social Security card for legal purposes that require him or her to have an SSN, including claiming him or her as a dependent on your tax return and opening a bank account in his or her name
  • You have adult dependents, such as your elderly parents, and you want them to receive government benefits

A Public Law limits the replacement of Social Security cards to three per calendar year and 10 in a lifetime. Cards issued to reflect changes to your real name or a work authorization legend do not count. Also, the SSA may grant exceptions to the set limits if you provide evidence from an official source to declare that you need a Social Security card.

How to Fill Out Form SS-5?

You can find a copy of Form SS-5 on the official SSA website, your local Social Security office, or an online database of legal forms.

Form SS-5 is a one-page document that requires your personal information. While the form is easy to understand, you must answer all the required sections carefully. Double-check your information before submitting the form to avoid any delay in your application.

In addition, to avoid any problems, make sure to provide all the needed details, following all instructions. Do not provide any false information. Purposely doing so in any legal document is punishable by law and can lead to penalties and imprisonment.

Section 1: Name
Provide your full legal name that would appear on your Social Security card. If applicable, also provide the name you had before you changed your name or got married or divorced, as this will help the SSA locate your previous records.

Section 2: Social Security Number Assigned
Use this line if you were previously assigned an SSN. Enter the number you have been using as your SSN.

Section 3: Place of Birth
Provide your place of birth, regardless if it is within the U.S. or in a foreign nation. Do not abbreviate.

Section 4: Date of Birth
Provide your date of birth following the format: MM/DD/YYYY.

Section 5: Citizenship
Select one of the options to determine your citizenship. According to the SSA, if you check “Legal Alien Not Allowed to Work” or “Other,” you must provide a document from a U.S. Federal, State, or local government agency that states why you need to have an SSN. You must also meet all the requirements to receive government benefits.

Section 6: Ethnicity
This section inquires whether you are Hispanic or Latino. Providing your ethnicity is voluntary and will be for informational and statistical purposes only. It does not affect SSA’s decision regarding your application.

Section 7: Race
Select one or more options that determine your race. Providing your race is voluntary and will be for information and statistical purposes only. It does not affect SSA’s decision regarding your application.

Section 8: Sex
Select your gender.

Section 9: Parent / Mother’s Name at Her Birth and SSN
Provide the full name of your mother on Section 9A at the time of her birth and her SSN on Section 9B. If the SSN is not known, you may check the “Unknown” box.

Section 10: Parent / Father’s Name and SSN
Provide the full name of your father on Section 10A and his SSN on Section 10B. If the SSN is not known, you may check the “Unknown” box.

Section 11: Previous Social Security Card
Determine if you have filed for or received an SSN before. If yes, answer Sections 12 to 13.<

Section 12: Name on Most Recent Social Security card
Provide your name as shown on your most recent Social Security card.

Section 13: Different Date of Birth
If you previously changed your date of birth on the card due to an error, provide on this section the date before the change. You may leave the section unanswered if your card shows your correct date of birth.

Section 14: Today’s Date
Write the date of your application.

Section 15: Daytime Phone Number
Provide your daytime phone number. The SSA might use this contact you.

Section 16: Mailing Address
Provide your mailing address where you would want to receive your Social Security card. You will receive your card within 7 to 14 days from your application date.

Section 17: Signature
Sign the form accordingly to confirm that all of the details you have provided are accurate and true.

Section 18: Relationship to the Applicant
Specify your relationship to the person in Section 1.

Required Documents

Regardless of the purpose of your application, you must submit supporting documents to prove your identity, including your age and citizenship status. It is advantageous to prepare and have the original copies of the required documents on hand before applying.

The SSA does not accept photocopies and only allows originals or copies certified by the issuing agency. A notarized photocopy of an original document is also not acceptable.

Evidence of Identity

Submit a U.S.-issued document that establishes your identity. It must clearly show your legal name and biographical information, such as your date of birth, age, or parents’ names, and physical information, such as your photograph or physical description, including but not limited to height, eye color, and hair color.

You may submit one of the following documents as proof of your identity:

  • U.S. passport
  • U.S. driver’s license
  • State-issued non-driver identity card

If you are not a U.S. citizen, submit your current U.S. immigration document and foreign passport with biographical information or photograph.

Evidence of Age

The SSA requires that you submit your birth certificate. In some cases, they may accept another document that shows your age. Other documents you may submit include:

  • U.S. hospital record of your birth
  • Religious record established before age five, showing your age or date of birth
  • Passport
  • Final Adoption Decree, showing that the birth information was taken from the original birth certificate

Evidence of U.S. Citizenship

In general, you must submit your U.S. birth certificate or U.S. passport. Otherwise, the other documents you may provide include:

  • Consular Report of Birth
  • Certificate of Citizenship
  • Certificate of Naturalization

Evidence of Immigration Status

  • If you are an immigrant, you must provide a current unexpired document issued by the Department of Homeland Security (DHS), showing the status of your residency, such as Form I-551, I-94, or I-766.
  • If you are an international student or exchange visitor, you must provide Form I-20, DS-2019, or a letter authorizing employment from your school and employer (F-1) or sponsor (J-1).

If you are not allowed to work in the U.S., the SSA can still issue you a Social Security card only if you need the number for a valid non-work purpose. The card will have a mark that shows you cannot work; thus, the SSA will notify the DHS if you work.

Submission of Form SS-5

First-time applicants above the age of 12 need to visit the nearest Social Security office or center for an interview. You may visit the SSA website to find Social Security offices or Social Security Card Centers near your area.

For tax purposes, almost all U.S. citizens get a Social Security card after birth for parents to claim their child as a dependent; thus, it is uncommon that a person does not have a card. An interview verifies if a citizen has never been issued a card or SSN before.

Applying in person is the fastest way to obtain a Social Security card, but you may also mail your SS-5 form. Just make sure to submit the form together with the required supporting documents.

Requesting a replacement card online through the SSA website is also available but only in some states. This method only allows applicants who are at least 18 years old and not requesting a change of name. You may set up your Social Security account to submit a card replacement request online.

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