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Statement of Claimant or Other Person
This form is completed by applicants for Social Security or Supplemental Security Income benefits or by beneficiaries of these programs or from other interested persons when there is no standard form which collects the needed information. The information is used by the SSA to process claims for benefits and for ongoing issues related to the above programs.
Form #:  SSA 795
Agency:  Social Security Administration
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
NEEDED
pdf Form Only 2 91562 [2] Printable Only Adobe Reader Download  

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