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Work Activity Report (Self-Employed Person) - Form SSA-820-F4

How to Obtain the Form

Below you will find Form in Portable Document Format (PDF). To print the PDF version, you will need the Adobe Acrobat reader software. If you do not already have this special software, see our page on downloading and printing PDF documents.

After you download the Adobe Acrobat Reader, come back to this page and download the PDF version of the SSA-821-BK:

SSA-820 in PDF Icon


 

How to Complete the Form

The claimant or his/her representative completes items 2 through 11. The SSA-820-F4 is considered to be a self-help form.

 

Where To Send The Form

 Print the PDF SSA-820-F4 on 8 ½ x 11 inch paper, complete and sign the form, and mail it to your local Social Security office, upon request. If you are not sure where your local office is located, try our Social Security Office Locator service or call 1-800-772-1213.  
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Last reviewed or modified Monday Jan 14, 2008
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