Form SSA-1 | Information You Need To Apply For Retirement Benefits Or Medicare

You can apply:

You can help by being ready to provide the information and documents listed below.

Information About You

  • Your date and place of birth and Social Security number;
  • The name, Social Security number and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death (if appropriate);
  • The names of any unmarried children under age 18, age 18-19 and in elementary or secondary school, or disabled before age 22;
  • Your bank or other financial institution's Routing Transit Number and the account number [more info];.
  • Your citizenship status;
  • Whether you or anyone else has ever filed for Social Security benefits, Medicare or Supplemental Security Income on your behalf (if so, we will also ask for information on whose Social Security record you applied);
  • Whether you have used any other Social Security number;
  • If you are applying for retirement benefits, the month you want your benefits to begin; and
  • If you are within 3 months of age 65, whether you want to enroll in Medical Insurance (Part B of Medicare).

Information About Your Work

  • The name and address of your employer(s) for this year and last year;
  • The amount of money earned last year and this year. If you are filing for benefits in the months of September through December, you will also need to estimate next year's earnings;
  • A copy of your Social Security Statement or a record of your earnings. If you do not have a Statement, you can view your Social Security Statement online by creating an account and signing in with us. Even if you do not have a record of your earnings or you are not sure if they are correct, please fill out the application. We will help you review your earnings when you apply;
  • The beginning and ending dates of any active U.S. military service you had before 1968;
  • Whether you became unable to work because of illnesses, injuries or conditions at any time within the past 14 months. If "Yes," we will also ask the date you became unable to work;
  • Whether you or your spouse have ever worked for the railroad industry;
  • Whether you have earned Social Security credits under another country's social security system; and
  • Whether you qualified for or expect to receive a pension or annuity based on your own employment with the Federal government of the United States or one of its States or local subdivisions.

Note

If you are outside the U.S., we may need to know if you worked or will be working over 45 hours a month outside the United States.

Documents You May Need To Provide

We may need to see certain documents in order to pay benefits. If you apply online, a list of documents we need to see will appear at the end of the application, along with instructions on where to submit them. The documents we may ask for are:

  • your original birth certificate or other proof of birth [more info] (You may also submit a copy of your birth certificate certified by the issuing agency);
  • proof of U.S. citizenship or lawful alien status if you were not born in the United States [more info];
  • a copy of your U.S. military service paper(s) (e.g., DD-214 - Certificate of Release or Discharge from Active Duty) if you had military service before 1968; [more info]; and
  • a copy of your W-2 form(s) [more info] and/or self-employment tax return [more info] for last year.

Important

We accept photocopies of W-2 forms, self-employment tax returns or medical documents, but we must see the original of most other documents, such as your birth certificate. (We will return them to you.)

Note

If our records show that documents proving age or citizenship/lawful alien status have already been submitted for an earlier Medicare or Social Security claim (such as Disability, Supplemental Security Income, etc.), you do not need to submit the documents again.

What If I Don't Have All Of The Documents?

Even if you don't have all the documents we need, you should still submit the application and any documents you do have. You can provide the missing documents later or we may be able to help you get them.

In many cases, your local Social Security office can contact your state Bureau of Vital Statistics and verify your information online at no cost to you. If we can't verify your information online, we can still help you get the information you need.

If you delay submitting the application, you could lose some benefits you may be due.

Mailing Your Documents

If you mail any documents to us, you must include the Social Security number so that we can match them with the correct application. Do not write anything on the original documents. Please write the Social Security number on a separate sheet of paper and include it in the mailing envelope along with the documents. If you do not want to mail these documents, you may bring them to a Social Security office.

Do not mail foreign birth records or any documents from the Department of Homeland Security (DHS), formerly the Immigration and Naturalization Service (INS), especially those you (the applicant) are required to keep with you at all times. These documents are extremely difficult, time-consuming and expensive to replace if lost. Some cannot be replaced. Instead, bring them to a Social Security office where they will be examined and returned.