Forms Catalog Document - SSA4641 :-: SSA :-: Authorization for the Social Security Administration to Obtain Records from a Financial Institution and Request for Records

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Authorization for the Social Security Administration to Obtain Records from a Financial Institution and Request for Records

Authorization for SSA to Obtain Records from a Financial Institution and Request for Records - Form SSA-4641-U2 provides financial institutions with the customer's authorization to disclose records, as required by Public Law 95-630. Responses to the questions are used, in part, to determine whether resource requirements are met in the Supplemental Security Income program.

Form #: SSA 4641 U2
Agency: Social Security Administration

	TYPE	PAGES	SIZE (KB)	CAPABILITY	WHAT'S NEEDED
	Form Only	4		[1] Paper Only	Other Client Software

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