Free Application For A Social Security Card (For People in US) SS 5 Form | PDF | WORD

This is an application for a Social Security Card(applicable for people in the US) Form number SS 5. You can also use this same form to apply for a replacement Social Security Form or to apply for a change or correction in your existing Social Security Number.

How to fill this Application for a Social Security Card?

  • In Section one You need to fill in the following details:
    • Your Name(as you want it to be displayed on your Social Security Card).
    • Full Name at Birth (If your Current name and your birth name is different).
    • any other Names you use.
  • Your Social Security Number if you have been assigned one previously.
  • Your place of Birth (in the form of city and State, or foreign country is you were born outside of the US)
  • Date of Birth.
  • You also have to provide your current citizenship status from the following:
    • U.S. Citizen.
    • Legal Alien allowed to Work.
    • Legal Alien Not Allowed to Work.
    • Other.
  • You can also State voluntary whether you are of Hispanic or Latino Ethnicity.
  • You can also State voluntarily if you are from one of the following races.
    • Native Hawaiian.
    • American India.
    • Alaska Native.
    • Black/African American.
    • Asian.
    • Other Pacific Islander.
    • White.
  • Next you Must mention your Sex whether you are Male or Female.
  • You Also fill in the following details.
    • Your Parent’s or Mother’s Name at her Birth.
    • Their Social Security Number if any.
    • Your Parent’s or Father’s Name at her Birth.
    • Their Social Security Number if any.
  • You have to declare if you have ever received a Social Security Number before.
  • If you have already received a Social Security Number Before you should enter it in section 12.
  • In section 13 you must enter your date of birth as shown in your previously received Social Security Card.
  • in Sections 14-16 you must enter the  following details:
    • Today’s Date.
    • Your Day Time Phone Number.
    • Your Mailing Address.
  • Then you must sign in the space given in the form.


To Submit this application the applicant must either mail this signed application with the necessary documents to any Social Security Office or the applicant can take it personally to the Social Security Office. You can visit to find your nearest Social Security office or Social Security Card Center services. To download form SS5 you just have to click on the link below.

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Application For A Social Security Card (For People in US) SS 5 Form

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