SSA-827 (with electronic signature(adult first person only)

Authorization to Disclose Information to the Social Security Administration

i3368 screenshots

SSA-827 (with electronic signature(adult first person only)

OMB: 0960-0623

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i3368 screenshots
Medical Release Page

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No Path

Medical Release Form in popup window

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Submit

Receipt

Next Steps not from iClaim

Next Steps from iClaim

Overview not from iClaim

Overview from iClaim


File Typeapplication/pdf
File TitleMicrosoft Word - i3368 screenshots.doc
Author177717
File Modified2011-06-17
File Created2011-06-17

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