SSA uses the SSA-795 to obtain information from claimants or other persons having knowledge of facts in connection with claims for Social Security benefits or Supplemental Security Income (SSI) payments when there is no standard form to collect the needed information. SSA then uses the information to process claims for benefits or for ongoing issues related to the above programs. The respondents are applicants and recipients, or others having knowledge of facts in connection with claims for Social Security or SSI.
The latest form for Statement of Claimant or Other Person expires 2021-11-30 and can be found here.
Document Name |
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Form |
Supporting Statement A |
Supplementary Document |