Forms Catalog Document - SSA5665 :-: SSA :-: Teacher Questionnaire

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Teacher Questionnaire

The information collected on forms SSA-5665 and SSA-5666 is used by SSA and the State Disability Determination Services to obtain descriptions of children claiming SSI benefits based on disability and their ability to function on a daily basis. The forms are used for initial determinations of eligibility, in appeals and in initial continuing disability reviews.

Form #: SSA 5665 BK
Agency: Social Security Administration

	TYPE	PAGES	SIZE (KB)	CAPABILITY	WHAT'S NEEDED
	Form Only	10	0	[2] Printable Only	Adobe Reader Download

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