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Claimant's Statement About Loan of Food or Shelter Statement About Food or Shelter Provided to Another
Claimant's Statement About Loan of Food or Shelter, Statement About Food or Shelter Provided to Another - The information obtained on forms SSA-5062 and SSA-L5063 is used by the Social Security Administration (SSA) to identify bona fide loans of food and shelter made to applicants for SSI benefits. This information will permit SSA adjudicators to determine an income value, if any, of food and shelter received by SSI applicants. SSA needs this information to determine eligibility for SSI benefits and the amount of benefits payable. Form SSA-5062 is completed by SSI applicants who seek to establish that food and/or shelter provided by another person is a loan that must be paid back. Form SSA-L5063 is completed by the person who provides the food and/or shelter to the SSI applicant. Together, these forms establish whether a bona fide loan exists between the applicant and the lender.
Form #:  SSA 5062
Agency:  Social Security Administration
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
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paper Form Only 1   [1] Paper Only Other Client Software  

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