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Form SSA-604 Certificate of Incapacity
Certificate of Incapacity
Revised Cert of Incap SSA604
Certificate of Incapacity
OMB: 0960-0739
OMB.report
SSA
OMB 0960-0739
ICR 201206-0960-006
IC 44832
Form SSA-604 Certificate of Incapacity
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0739 can be found here:
2019-07-22 - Revision of a currently approved collection
2016-05-17 - Revision of a currently approved collection
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