Completion Guidelines

All entries on the SS-5 must be legible and printed (or typed) in blue or black ink. Since the SS-5 is used at the SSA Office as a data entry document, legibility is essential to correct entry of the information by the SSA Office.

All fields should be completed or marked "Unknown" if they can't be completed.

All entries must agree with the evidence submitted by the client.

  1. NAME: Make sure the names are spelled correctly. Also be sure that the last name does not start on the line where the middle initial belongs as this may cause errors.

    Examples: The client's name is Rip Van Winkle, but the Van is entered above the place for the middle initial so the client's name is entered on SSA's computer as Rip V. Winkle. If yu enter a Jr., Sr., or Roman numeral after the name, this must also be used on WCE and/or FSP; the names must match exactly.

    THE NAME ON THIS LINE MUST MATCH THE NAME ON WCE AND/OR FSP EXACTLY!

    Full Name at Birth if Other Than Above: Fill this in only if the name to be shown on the card is different than the name given at birth.

    Other Names Used: Complete this if the client has been known by any other name, e.g., due to marriage. This is important for screening purposes to avoid assigning duplicate numbers.

  2. MAIL ADDRESS: This should be the address where the Social Security card is to be mailed.
  3. CITIZENSHIP: This should also be checked U.S. Citizen since all aliens must be referred directly to the SSA Office.
  4. SEX: The sex of the individual. THIS MUST MATCH THE SEX ON WCE AND/OR FSP EXACTLY! When a child is born, make sure the sex on WCE is changed to Male or Female.
  5. RACE: The race/ethnic description of the individual.
  6. DOB: The date of birth of the individual. Check this field carefully to make sure that numbers have not been transposed, e.g., 1987 entered as 1978. It is essential that correct data be entered in this field for proper screening of the Numident file and for establishing the correct information on the Numident file. THIS MUST MATCH THE DOB ON WCE AND/OR FSP EXACTLY!
  7. PLACE OF BIRTH: The city and state where the individual was born. It is important to enter correct data in this field for proper screening of the Numident file.
  8. MOTHER'S MAIDEN NAME: The maiden name of the individual's mother.

  9. FATHER'S NAME: The name of the individual's father.

    Complete fields 10 through 13 if the individual has previously received an SSN. This would include replacing a lost card or making a correction.

  10. PRIOR SSN: If the individual listed in number 1 has ever applied for or received an SSN, it is essential that this field be completed correctly for proper screening to avoid issuing duplicate SSN's.
  11. ENTER SSN: If the individual has previously received or alleges to have received an SSN, it must be entered in this field. This is essential to assist in screening and to avoid issuing duplicate SSN's.
  12. ENTER NAME: If the individual has previously received or alleges to have received an SSN, enter the name on the most recent card issued. If you are attempting to change the name on the SSA record, e.g., entering a new name in field 1, this field MUST be completed with the old name.
  13. ENTER DOB: If the individual has an incorrect birthdate on SSA;s files and you are attempting to correct the DOB in field 6, you MUST complete this field with the old DOB.
  14. TODAY'S DATE: Enter the date that the SS-5 is being completed and signed.
  15. PHONE NUMBER: Enter the daytime phone number where the individual may be reached, if any.
  16. SIGNATURE: The SS-5 should be signed by one of the following individuals:
    1. The person listed in line #1, for whom the SSN application is being made;
    2. If the individual in #1 is age 17 or younger or age 18 or older and physically or mentally incapable of signing, the following individuals may sign:
      1. Natural parent;
      2. Adoptive parent;
      3. Stepparent;
      4. Legal guardian/conservator; or
    3. An HHS employee if the child is a Department ward.
    4. If someone other than the person listed in #1 signs the SS-5, s/he must provide evidence of his/her own identity and this must be documented in the "Evidence Submitted" field. If a Department worker signs SS-5 for a Department ward, another worker must certify that s/he has seen the evidence of the ward's identity.
  17. RELATIONSHIP: Indicate the relationship of the individual signing the form to the individual in #1.

Certifying the SS-5