
0960-0045 STATEMENT OF CLAIMANT OR OTHER PERSON NAME OF WAGE EARNER, SELF-EMPLOYED PERSON, OR SSI CLAIMANT SOCIAL SECURITY NUMBER NAME OF PERSON MAKING STATEMENT (If other than above wage earner, self-employed person, or SSI claimant) -
Form ssa-795 (09-2015) ef (09-2015). destroy prior or ssi claimant. understanding that this statement is for the use of the social security administration, i hereby certify that - statements or forms, and it is true and correct to the best of my...
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