YOUR SECOND SOCIAL

SECURITY NUMBER
GUIDE

This is a do it yourself package. We do not service this

package because you are to do this yourself. There are
no refunds as results vary according to the individual
that are in the hands of the IRS or SSA. Please allow up
to 4-6 weeks to receive your 2nd Social Security
number. If the office you send the application to denies
you, send it to another office in another state. Any
questions will incur a separate upfront consultation fee
of $100. There should be no need for difficulty since the
package is extremely self explanatory. Send all original
ID docs certified return receipt or Express mail. All
rights reserved. There are no refunds since you are in
receipt of this package and just paid for this
information as results WILL vary and only up to the
SSA. No part of this publication may be reproduced,
stored or maintained in a retrieval system and or
transmitted in any form or by any means,

Copyright 2012

electronic, mechanical, photocopying, recording, or

otherwise whether or not this means presently existing
or shall exist in the future, without the prior written
permission .

This publication is designed to provide accurate and

authoritative information in regard to the subject
matter covered herein. It is sold with the understanding
that the publisher is not engaged in rendering legal,
accounting, or other professional service. If legal advice
or other expert assistance is required, the services of a
competent professional person should be sought.

TABLE OF CONTENTS

INTRODUCTION

PART ONE
SECTION ONE
How To Understand Your Credit
Report And Detect If Your Social
Security Number Is Being Used
SECTION TWO
How To Apply For Your Second
Social Security Number

PART TWO
SECTION ONE
How To Receive And Properly Use
Your Third Number Option
SECTION TWO
Forms Necessary To Apply For An
Employer Identification Number And
Taxpayer Identification Number

PAGE 2

PAGE 3

PAGE 13

PAGE 21

PAGE 27

PART THREE
Forms Useful In Disputing
Negative Credit

PAGE 33

PART FOUR
Complimentary Listing Of Over
100 Bank, Retail, & Gas
Credit Companies

PAGE 47

When Kevin and Mary were newlyweds, they went through rough times
and had trouble paying their bills. They received many credit card offers and
quickly succumbed to the allure of easy credit. Kevin and Mary wanted to buy
more things than they could afford and charging was an easy way of getting what
they wanted. Years later, Kevin was forced to take a pay cut and the couples
income was severely cut. With too much credit card debt and a lower monthly
income, Kevin and Mary again experienced difficulty paying their bills. Soon their
financial trouble became serious. However, with the help of Consumer Credit
Counseling Service (CCCS) , Kevin and Mary were eventually able to recover
from their money problems and pay off their debts. CCCS is a national nonprofit
organization with local chapters around the country that help consumers in
financial difficulty.
Kevin and Mary's credit histories were seriously damaged but they wanted
to buy a home; in order to do so they needed to rebuild their credit. As part of
their rebuilding process, they requested copies of their credit report from each of
the big three credit bureaus. This was done in order to correct and identify any
problems in their credit files. However, early in the process they became
frustrated because of inaccurate information. Mary and Kevin were successful in
getting the errors deleted from their credit file but often the misinformation would
reappear.
This couple's problems are not unusual. Many consumers ruin their credit
by taking on more debt than they can handle. As a result, they must face the
challenge of correcting any problems in their credit records and rebuilding their
credit in order to borrow money at reasonable termsa process that can take
years. You are responsible for your credit record problems, but not responsible
for misinformation. Perhaps the misinformation results from debts which were
paid but are listed as unpaid. Many consumers learn that addressing credit record
problems sometimes requires patience and perseverance. Within this booklet you
will learn how to correct credit record errors and inaccuracies and how to deal
with credit record omissions. You will also find out how to request your 2nd Social
Security Number. The story that you've just read is only one scenario that may
result in a request for a 2 nd Social Security Number, but the reasons for
requesting are as many as their are stars in the sky. Many consumers feel disadvantaged or subjected to negative economical or personal hardship- due to
their credit file being tied to their Social Security Number. They are unable to
obtain credit and for that reason we have devised a simple set of guidelines to
use in your petition for a 2nd Social Security Number which can accommodate any
situation.
No firm number exists to show the percentage of credit files that have
problems. During the early 1990's, estimates ran as high as 50% but given
industry efforts to reduce that rate, the percentage is probably lower today. In
addition, some of the amendments to the FCRA are intended to further reduce
the incidence of credit record problems. Realistically however, given that the

industry collects more than 2.5 billion pieces of credit-related information each
month and generates more than 600 million credit reports on close to
200 million consumers every year, there are bound to be errors in some credit
files. Credit bureaus do make mistakes. Also, sometimes creditors and other
information providers give credit bureaus incorrect information. Therefore, to
protect yourself, read your credit report carefully! We have supplied you with
some tools to assist you with this sometimes frustrating and confusing task which
will make it simpler.

Common Credit Record Errors:

Information is commingled. Your credit record includes information for
someone with a name similar or identical to yours.
The name of a former spouse appears on your credit record.
Your name is misspelled, your address is wrong or your Social Security
Number is incorrect.
Duplicate accounts show up.
Account information is inaccurate or incomplete. For example, information for
an account shows that you were delinquent for several months a year ago, but
fails to show that you caught up and have paid on time for the past nine
months. Other problems could include incorrect account balances and
reporting paid-of or closed accounts as open.
Outdated information is included. In most cases, a credit reporting agency is
legally permitted to maintain and report negative account information about a
consumer for (7) years and bankruptcies for (10) years.
Account information does not relate to you.
Unauthorized inquiries are listed.
There is a failure to show that a tax lien has been released.
\

PART ONE

SECTION ONE

How To Understand Your Credit Report

And Detect If Your Social Security
Number Is Being Used

Dealing with Inaccurate or Outdated Information That

Reappears in Your Credit Record
The FCRA now requires credit reporting agencies to maintain " reasonable
procedures designed to prevent the reappearance of deleted information."
Because the law does not define " reasonable procedures," however, the actual
impact of this new provision remains to be seen. On the other hand, the revised
law also states that before deleted information can be reinserted into your credit
file, the provider of the information must certify in writing that the information is
indeed complete and accurate. Furthermore, the credit bureau must notify you in
writing, within five business days, that the information has been reinserted;
provide you the name, address, and phone number, if "reasonably available," of
the information provider; and explain your right to add a statement to your credit
file about the disputed information.

When a Credit Bureau's Investigation Does Not Correct a

Credit Record Problem
It's possible that a credit bureau's investigation will find that the information
your are disputing is actually correct. If this occurs, you have several options.
One option is to locate new or additional documentation that helps support your
case. Make copies of any such documentation, write the credit reporting agency,
and staple everything together. Be sure to make a copy of the letter for your files
and send the materials by certified mail with a request for a return receipt.
Another option is to contact the provider of the information you are disputing and
ask that they correct the problem. Prepare a letter similar to the one you mailed to
the credit bureau and include with it copies of your backup information. In your
letter, ask that the creditor send a correction to all of the credit bureaus it reports
to as well as to you. Also, ask that the information provider direct those credit
bureaus to correct your credit file. To make certain that the information provider
follows your instructions, ask to be sent a copy of the letter(s) that it sends to
each credit bureau. A third option for resolving a credit record problem is to call
your state attorney general's office of consumer affairs to see if they can help
you. Many states have their own credit reporting laws.

Written Statement
If a credit bureau notifies you that the information you are disputing is
correct, they must tell you about your fourth option. Prepare a written statement
of no more than 100 words to dispute the information which can be put into your
credit file. Use the statement to explain why you believe the information in your
credit file is in error. By law your statement must become a permanent part of
your credit file and must be provided to anyone who reviews your credit record. If

you need help writing your statement, FCRA requires that credit reporting
agencies make a staff person available to assist you.

The Experian Credit Report

This report's straightforward narrative format makes it extremely easy to
read. The report comes with a reinvestigation request form for consumers who
find problems in their credit reports.

Consumer ID Number
Experian gives each consumer an ID number that's at the top of the first
page of the sample report. Use this number if you have to call or write Experian
about information in your credit report.

Credit History
Like the credit reports of Trans Union and Equifax, Experian's begins with
your credit history. Credit history information is presented under two headings,
Account and Description. The accounts under the first heading are listed in
alphabetical order and includes an address and an account number for each. The
descriptive information is to the right of the account name, address, and number.
It includes the date the account was opened, its terms of payment, who has
contractual responsibility for paying the account, the account's credit limit, and its
high balance.
If the account is a bank loan, the descriptive information includes the date
the loan was taken out, the terms of the loan (number of years to pay it off), who
has responsibility for the loan payments, and the original amount of the loan.

Other Account-Related Information

Below the account and description information you will find several lines of
information summarizing each account's payment history, including whether
account payments are current, whether all payments have been made on time,
the scheduled monthly payment, the first time the account was reported to
Experian, the balance due on the account as of a certain date, and the number of
months of account information Experian reviewed. Also shown in this section of
the report are notations as to whether an account was closed by the consumer or
by the creditor.

Public Record Information

Experian is the only bureau of which the big three presents public record
information in the credit history section of its report. In fact, any public record
items in your credit file will be listed before any of your credit accounts. There is
no public record information in the sample report.

Inquiries
The inquiries section of the Experian credit report, "Your Credit History
Was Reviewed By", follows the credit history section. It lists the names and
addresses of companies that asked to review your credit history, the date of the
rrequest, and the reason for the request. Experian, alone of the big three
bureaus, provides detailed information regarding inquires.

Identification Information
The last part of the Experian credit report presents your personal
identification information. This section begins by listing your name, address,
Social Security number, date of birth, and name of your spouse this is information
that you provided Experian when you requested a copy of your credit report.
There is also additional identifying information about you provided by Experian's
subscribers. That information includes your driver's license number, current and
former addresses, and employer information.

The Trans Union Credit Report

Figure 3.2 is a sample Trans Union credit report. Of the big three
agencies, it is the most difficult to understand. The Trans Union report comes
with an investigation request form that serves the same purpose as the Equifax
research request form. Use this form to dispute information in your credit report.

Identifying Information
Your name, Social Security Number, current address and any former
address reported, your birth date, and your phone number will appear close to the
top of your Trans Union Credit report. Information on your current and former
employers may also appear here, although there is no such information on the
sample report.

Credit History
Your history with creditors who report to Trans Union follow the identifying
information. Account information is presented under a series of headings. To the
far left under these headings is the name of the creditor reporting to Trans Union
and below that, your account number. The series of numbers and letters to the
immediate right of each creditor's name represents a creditor's subscriber code;
you do not need to be concerned with these codes.
Below your account number is series of letters or codes indicating whose
responsibility it is to pay the account. Trans Union uses nine different letters.
Reading the sample credit report, you will note that most of the accounts are
designated as "I", or individual accounts. On this same line there may also be
information regarding any collateral that was used to secure the credit. For
example, on the same credit report, you'll note that the Frost Bank Loan for
$14,400.00 was secured with a piece of real estate, "lot 3A amended plat."
On the same line as the creditor's name but to the right is the date the
account was opened, the most ever owed on the account, and the date that the
credit information on the account was reported to Trans Union. Following that
date is a letter (C, F, P, A, or V), which designates the status of the account such
as closed, written off or paid off. Below that block of information is the credit limit
for the account and the date the account was closed, if applicable. Looking at the
Wells Fargo account on the sample credit report, you will see that the account
credit limit was $3,000.00 and that the account was closed in 7/93.
If you continue reading to the right, the block of information labeled,
present status shows the account balance as of the date the account information
was verified by Trans Union or the account was closed, and any past due amount
as of the same date. Below that information is delinquency, the dollar amount of
that delinquency, and how the account was being paid at the time of the
delinquency.
Finally, below the delinquency information may be information describing
the kind of credit the account represents, for example: credit card, real estate, or
automobile, boat, or personal loan.
The next large block of information to the right, "Payment Pattern" provides
detailed payment history information for each account in your report. Up to 24
months' worth of information is provided. Read the symbols in this section from
left to right. The most current information is to the far left of the top line. You will
see either a number or Xs as you read. A 1 means that your account payment
that month was on time; 2 through 8 indicate different degrees of lateness; X
means that no information was provided by the creditor for that particular month.
An explanation appears on the reverse side of the very last page of your Trans

Union credit report explaining what each number means. The explanations will be
under the heading: MOP Current Manner of Payment.
The final block of information to the far right of the Trans Union report
indicates the account type and current method of payment (MOP). Types of
accounts include revolving, open, installment, mortgage, and so on. Current
method of payment reflects the timeliness of the payments you make on an
account. Most of the accounts on the sample credit report are revolving (R) and
are paid within 30 days (01).
The very bottom line of information for each account presents
miscellaneous additional remarks about the account, for example: that account
information is being disputed. There are no miscellaneous additional remarks in
the sample credit report.

Inquiries
This information follows the credit history section of the Trans Union
report. Like the reports of the other credit reporting agencies, the inquiries section
shows who has made an inquiry regarding your credit report and the date of each
inquiry. The designation "Consum Disci" in the sample report indicates that the
consumer requested a copy of his or her own report.
Following the inquiries is a list of the companies to whom Trans Union
provided the consumer's name and address, so the companies could offer the
consumer credit insurance, and the dates the information was provided. The
sample report shows that Trans Union provided such information six times from
9/96 to 1/97.

Public Record
The public record section of the Trans Union report presents the usual
information on any applicable liens, bankruptcies, or judgments.

The words End of Credit Report designate the final page of the Trans
Union report. Immediately following these words are the addresses and phone
numbers of the credit bureaus affiliated with Trans Union that generated the
report. On this report it is Sarma Central Texas in San Antonio. Contact the office
listed here if you have any questions about the information in your Trans Union
Credit report.

FIGURE 3.2 Sample Trans Union Credit Report

Note: This is a copy of an actual credit file. Identifying information (i.e., name,
address, Social Security number, date of birth, account numbers, etc.) has been
removed to protect consumer's identity

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PAGE 1
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PAGE 8
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REPORT SERVICED BY:
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1301 BROADWAY
SAN ANTONIO. TX. 76215
512-459-7376
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PART ONE
SECTION TWO

How to Apply for Your

Second Social Security Number

PREFACE
PART ONE, SECTION TWO
According to the Social Security Administration any individual who feels that their
current social security number is causing them to be "disadvantaged and/or subjected
to negative personal or economic problems or hardships" is entitled to request a new
social security number. These are very broad guidelines and below we have listed some
additional reasons for which you may be approved for a new social security number. The
information contained herein has been created and copyrighted by Primary Source. We
guarantee that the information contained in this manual is 100% factual and that it's
produced but not fully disseminated by the Social Security Administration. Your local
social security administration branch manager views each case individually and judges
each case on its own merit and how it fits within the parameters of the guidelines for
approving requests for 2nd social security numbers.
Please note that the reasons for which you may be approved are in no way limited to the
following:
NOTE: PLEASE US E TH E "R EQUEST FOR SOCIAL S ECURITY
STATEMENT" FOUND ON THE FOLLOWING PAGE TO CHECK IF THE
SOCIAL SECURITY ADMINISTRATION HAS MIXED TOGETHER YOUR
EARNING RECORDS WITH SOMEONE ELSE.
Credit record problems/abuse

Rape

Credit card theft

Threats of bodily harm and/or death.

3rd party use to obtain economic gain.

Harassment by another party who

is
tracing you through your number.

Identity theft, as well as personal information

theft.

Religious objections or concerns.

The SSA & IRS have mixed together your
earnings records with someone else.

Criminal record problems as a

result of someone using your
number.

Unauthorized merging of credit records with

someone else.

Bankruptcy resulting from fraud and/or

unauthorized use of your number.

Identical name cases

Victims of harassment or abuse, example
(but in no way limited to) battered spouses or
lovers.

Financial distress that resulted from

the misuse of your number and/or
was the result of unpaid financial
obligations preceding a divorce.

Domestic violence victims.

Following a divorce, financial obligations not

met through no fault of your own and impacted
you economically.

Stalkings

12

Form Approved
OMB No. 0960-0466

SP

Request for Social Security Statement

Pleas e check this box if y o u w ant
to get yo ur s tatem ent in Spanis h
ins tead of Englis h.

Pleas e print or type your answ ers . When yo u

have co mpleted the fo rm , fo ld it and mail it to us .
( I f y o u pr ef e r to s en d y o ur r e qu es t us i ng t h e
Internet, contact us at www.ssa.g oy)

1 . N am e s ho w n o n yo ur So cial Security card:

For items 6 and 8 show only earnings covered by

Social Securi ty. Do NOT include w ages f rom
Sta te , lo cal o r F ede ra l G o v er nm e nt em plo y m e n t
that are N OT co v ered f o r So cial Sec u rity o r tha t
are co v ered ON L Y by M edicare.
6 . Show y our actual earnings (wages and/o r net
s e l f - em p lo y m e n t i n co m e ) f o r l as t y e a r a n d
y our es timated earnings fo r this y ear.

9 . Do y o u w ant us to s e nd t he s ta tem e nt :

To you? Enter your name and mailing

address.
To s ome one e ls e (yo ur a cco unta nt,
pension plan, etc.)? Enter your name with "c/o "
and the nam e and addres s of that perso n o r
o rganizatio n.

or Street Address (Include Apt. No., P.O. Box, Rural Route)

A. Last year's actual earnings: (Dollars Only)

Street Address

B. This year's estimated earnings: (Dollars Only)

First Name

Stre et Addr ess If Foreign Addre ss, ent er Ci t y, Provinc e, Post al Code)

Middle Initial

U.S. Cit y, S ta te, Zip code If Foreign Addre ss, ent er Na me of Cou nt ry

Last Name Only

2 . Yo ur So cial Security number as s how n o n

your card:

3. Y o u r d a t e o f b i r t h ( M o - D a y- Y r . )

4 . Other So c ial Secu rity num bers y o u hav e us ed:

7. Show the age at which you plan to stop

w o rk ing

NOTICE:

(Show only one age)

8. Below, show the average yearly amount (not

y our to tal f uture lif etim e earnings ) that y ou
th ink y o u w il l ea rn b etw e en no w and w he n
y o u plan to s to p w o rk ing. I nclude
perfo rmance or s cheduled pay increases or
bo nus es , but no t co s t- of - liv ing increases .
I f y o u ex pect to earn s ignif icantly m o re o r les s
in the f uture due to promo tio ns , jo b changes ,
part- tim e w o rk , o r an abs ence f ro m the w o rk
force, e nter the amo unt tha t most close ly
reflects yo ur future average y ea rly earnings .
I f yo u do n't ex pect any s ignif icant changes ,
s ho w the s am e amo unt yo u are earning now
(the amount in 6B).

5 . Yo ur Sex :

Male

Female

I am asking for information about my own Social

Security record or the record of a person I am
authorized to represent. I understand that if I
deliberately request information under false
pretenses, I may be guilty of a Federal crime and
could be f ined and/o r impriso ned. I authorize yo u
to use a contractor to send the Social Security
Statement to the perso n and addres s in item 9 .

Please sign your name (Do Not Print)

Future average yearly earnings: (Dollars Only)

Date

0
Form SSA 7004 SM (6-2002) EF (08-2002)
Destroy prior editions
-

(Area Code)

Daytime Telephone No.

SOCIAL SIVVRI

About The Privacy Act

Social Security is allowed to collect the facts on this
form under section 205 of the Social Security Act. We
need them to quickly identify your record and prepare
the statement you asked us for. Giving us these facts is
voluntary. However, without them we may not be able
to give you a statement. Neither the Social Security
Administration nor its contractor will use the
information for any other purpose.

ADN1INISIRM ION

Request for Social Security

Statement
Thank you for requesting this statement.

in

After you complete and return this form, we will -within 4 to 6 weeks -- send you:
a record of your earnings history and an estimate of how much you have paid

Social Security taxes, and

estimates of benefits you (and your family)
may be eligible for now and in the future.
Paperwork Reduction Act Notice and Time It Takes
Statement
The Paperwork Reduction Act of 1995 requires us to
notify you that this information collection is in
accordance with the clearance requirements of section
3507 of the Paperwork Reduction Act of 1995. We may
not conduct or sponsor, and you are not required to
respond to, a collection of information unless it displays
a valid OMB control number. We estimate that it will
take about 5 minutes to complete this form. This
includes the time it will take to read the instructions,
gather the necessary facts and fill out the form.

We're pleased to furnish you with this information and

we hope you'll find it useful in planning your financial
future.
Mail completed form to:
Social Security Administration
Wilkes Barre Data Operations Center
P.O. Box 7004
Wilkes Barre, PA 18767-7004

Social Security is more than just a program for retired

people. It helps people of all ages in many ways.
Whether you're young or old, male or female, single or
married -- Social Security can help you when you need it
most. It can help support your family in the event of
your death and pay you benefits if you become severely
disabled.
If you have questions about Social Security or this form,
please call our toll-free number, 1-800-772-1213.
0\1.1, SEct,,t,

s>'141N

111111

'6,01

INTRODUCTION
Part One, Section Two of this booklet is designed to provide you with simple step
by step instructions for preparing a successful request for a second Social
Security Number. The following guidelines have been produced by Primary
Source to assist individuals who feel they are deemed eligible to receive a new
Social Security Number. If your Social Security Number is causing you to be
financially disadvantaged, you may submit a request for a new Social Security
Number by following the guidelines provided.
THE MOST SIMPLE JUSTIFICATION FOR REQUESTING A SECOND SOCIAL
SECURITY NUMBER
The following reasons for requesting a second Social Security Number appear as
outlined by the Social Security Administration:
The most common justification is that the Social Security Administration or
the Internal Revenue Service has mixed together earnings records from more
than one person, if this has happened to you and the other party cannot be
located, it will be necessary for you to be issued a new number.
One of the easiest situations that the Social Security Administration accepts
justifying a new number is if your Social Security Number contains the sequence
666 or 13. The digits need to be consecutive according to the Social Security
Administration policy manual, but may be separated by hyphens.
Example:
735-13-9786-This is acceptable means for requesting a new number because the
numerical order of the one and three are consecutive.
735-01-3978-This is also acceptable means for requesting a new number even if
the one and three are separated by hyphens.
619-05-6668-This is acceptable means for requesting a new number because the
numerical order of the sixes are consecutive.
619-06-6688-This is also acceptable means for requesting a new number even if
the sixes are separated by hyphens.
The Social Security Administration states that you don't have to prove that your
religious objection is sincere. Other commonly accepted complaints include that
someone is harassing you and is tracing you through your Social Security
Number, sequential numbers assigned to family members, or serious impact on
your credit history that you've tried to clear up without success. You will find
helpful forms contained in the back of this booklet for disputing negative credit
information.

13

HOW TO APPLY FOR A SECOND SOCIAL SECURITY NUMBER DUE TO

ECONOMIC OR PERSONAL HARDSHIP
The following steps are simple, but effective. These guidelines have successfully
assisted many clients in their petition for a new Social Security Number.
STEP 1-Writing your request for a Second Social Security Number

Begin by writing down the reasons you believe you are deserving of a 2nd
Social Security Number.
Explain how your current situation came about, causing you to resort to
believing that receiving a 2nd Social Security Number will alleviate your
unfavorable situation.
Include why this current situation is disadvantageous to you, or subjecting you
to negative economic or personal hardships.
If you feel that this situation is affecting your emotion well-being, causing a
loss of personal freedom or a threat to your personal safety, be sure to include
this in your petition.
Be sure to include at what point in time this situation arose. The situation that
you based your request for a new Social Security Number should have
occurred within the last year, or it still must be affecting you today.
When possible, document your claims. For example, include references to
denied requests for credit, denied requests for a home mortgage, credit report
disputes, court records, police reports, etc. Include copies of these documents
with your request for a new Social Security Number.
Conclude your petition by emphasizing how a new Social Security Number will
alleviate the problems caused by your old Social Security Number.

14

DEVELOP YOUR CASE

WHAT?
WHAT HAPPENED? WHAT WAS DONE TO YOU AND BY WHOM?

DEVELOP YOUR CASE

WHY?
WHY ARE YOU REQUESTING A NEW SOCIAL SECURITY NUMBER?

DEVELOP YOUR CASE

HOW?
HOW HAS THIS CAUSED YOU TO BE DISADVANTAGED OR SUBJECTED TO ECONOMICAL
HARDSHIP? HOW HAS THIS CAUSED YOU TO LOSE YOUR PERSONAL FREEDOM OR FEAR
FOR YOU SAFETY? HOW HAS THIS AFFECTED YOUR EMOTIONAL WELL BEING?

DEVELOP YOUR CASE

WHEN?
WHEN DID THIS OCCUR? IT MUST HAVE HAPPENED WITHIN THE LAST YEAR OR IT COULD
HAVE HAPPENED FURTHER IN THE PAST BUT THE PROBLEM ITSELF CONTINUES NOW AND
IT'S STILL AFFECTING YOU TODAY.

DEVELOP YOUR CASE

WHO?
WHO CAN ATTEST TO THESE FACTS AND WHAT IS THE BASIS OF THEIR KNOWLEDGE. IS
THIS PERSON AN UNBIASED THIRD PARTY SUCH AS AN ATTORNEY, ACCOUNTANT,
POLICE OFFICER, EYEWITNESS, OR IS THE INFORMATION YOU SUBMIT IN SUPPORT OF
YOUR CASE FROM AN UNBIASED THIRD PARTY SUCH AS COURT RECORDS, STATEMENTS
FROM A CREDIT BUREAU, POLICE REPORTS, A DENIED APPLICATION FOR CREDIT OR A
HOME MORTGAGE, A DIVORCE DECREE, A LAWSUIT, BANKRUPCY DOCUMENTATION AND
SOON.

STEP 2 - Properly Formatting Your Request

Your petition for a second Social Security Number should be typed in a uletter
format". At the top left corner of the petition, list your full name and your Social
Security Number as it appears on your present Social Security Card, along with
your current mailing address and telephone number. At the top right corner, be
sure to include the date your petition was submitted. Be sure to refer to the
sample petition below.
Full Name
Social Security Number
Current Address
Telephone Number

Date

To whom it concerns:

Sincerely,
Your Signature

STEP 3 - Contacting your local Social Security Administration office

You need to contact your local Social Security Administration branch to obtain
their address and telephone number. You may do this by contacting the main
office in Baltimore, Maryland at: (410) 361-4600. Or you can contact your local
directory assistance service.
STEP 4- Complete your SS-5 form

Enclosed within this booklet is a SS-5 form. Although you may already have a
Social Security number at the present time, it is necessary for you to complete
this form to receive a new Social Security Number.
STEP 5 - Simply mail your request!

Mail your request to your local Social Security Administration office.

Congratulations! You have now successfully submitted an absolutely perfect
request for your new Social Security Number!
15

SOCIAL SECURITY ADMINISTRATION

Application for a Social Security Card
Applying for a Social Security Card is easy AND it is FREE!
If you DO NOT follow these instructions, we CANNOT process your application!
STEP 1

Complete and sign the application with BLUE or BLACK ink.

Do NOT use pencil! Follow instructions below.

STEP 2

See Page 2 to determine what evidence we need.

STEP 3

Submit the application and evidence to any Social Security office. Follow instructions
below.

HOW TO COMPLETE THE APPLICATION

Most items on the form are self-explanatory. Those that need explanation are discussed below. The
numbers match the numbered items on the form. If you are completing this form for someone else,
please complete the items as they apply to that person.
2. Show an address where you can receive the card 3 to 6 months from now.
3. If you check "other" for CITIZENSHIP, provide a document from the Federal/State or local
agency explaining why you need a Social Security number and that you meet all the
requirements for the benefit or service except for a number.
5. You do not have to complete this item about race/ethnic background. We use this
information for statistical reports on how Social Security programs affect people. We do not
reveal the identities of individuals.
6. Show the month, day, and full (4-digit) year of birth, for example, "1998" for year of birth.
8. You must enter the mother's Social Security number in item 8B. if you are applying for a
number for a child under age 18.
9. You must enter the father's Social Security number in item 9B. if you are applying for a
number for a child under age 18.
13. If the date of birth you show in item 6 is different from the date of birth you used on a prior

application for a Social Security number card, show the date of birth you used on the prior
application and submit evidence of age to support the date of birth in item 6.
16. You must sign the application if you are age 18 or older and are physically and mentally

capable. If you are under age 18, you may also sign the application if you are physically
and mentally capable. If you cannot sign your name, you should sign with an "X" mark and
have two people sign as witnesses in the space beside the mark. If you are physically or
mentally incapable, generally a parent, close relative, or legal guardian may sign the
application. Call us if you need clarification about who can sign.

HOW TO SUBMIT THE APPLICATION

Mail the form and your evidence documents to the nearest Social Security office with a tracking number,
return receipt. We will return your documents to you. If you do not want to mail your original documents,
take them to the nearest Social Security office with this application.
If you are age 18 or older and have never been assigned a number before, you must apply in
person.
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EVIDENCE WE NEED
CAUTION: We cannot accept photocopies of documents. You must submit original documents
or copies certified by the custodian of the record. Notarized copies are not acceptable. If your
documents do not meet this requirement, we cannot process your application. We will return your
documents. IF YOU DO NOT WANT TO MAIL YOUR ORIGINAL DOCUMENTS, TAKE THEM TO
ANY SOCIAL SECURITY OFFICE.
If you need an ORIGINAL CARD (you have NEVER been assigned a Social Security number before),
you must show us proof of :
AGE,
IDENTITY, and
U.S. CITIZENSHIP or LAWFUL ALIEN STATUS
If you need a DUPLICATE CARD (no name change), you must show us proof of IDENTITY.
IMPORTANT:

If you were born outside the U.S., you must also show us proof of
U.S. CITIZENSHIP or LAWFUL ALIEN STATUS.

If you need a CORRECTED CARD because of a name change, you must show us proof of IDENTITY.
To CHANGE YOUR NAME on our records, we need one or more documents identifying you by your
OLD NAME on our records and your NEW NAME.
IMPORTANT:

If you were born outside the U.S., you must also show us proof of
U.S. CITIZENSHIP or LAWFUL ALIEN STATUS.

AGE: We prefer to see your birth certificate. However, we can accept other documents such as a
hospital record of your birth made before you were age 5 or a religious record made before you were
three months old. If you were born outside the U.S., we can accept your passport. Call us for advice if
you cannot obtain any of these documents.
IDENTITY: We must see a document in the name you want shown on the card. We can generally
accept a current document that has enough information to identify you (e.g., signature, name, age,
date of birth, parents' names). We CANNOT ACCEPT a BIRTH CERTIFICATE, HOSPITAL BIRTH
RECORD, SSN CARD, SSN CARD STUB, OR SSA RECORD. Some documents that we can accept
are:
Driver's license
Employer ID card
Passport

Marriage or divorce record

Adoption record
Health Insurance card (not
a Medicare card)

Military records
Insurance policy
School ID card

IMPORTANT: If you are applying for a card on behalf of someone else, we must see proof of
identity for both you and the person to whom the card will be issued.

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NAME CHANGE: If your name is now different from the name shown on your card, we need an
identity document that identifies you by BOTH your old name AND your new name. Examples
include a marriage certificate, divorce decree, or a court order that changes your name. Or we can
accept two identity documentsone in your old name and one in your new name. (See IDENTITY
for examples of identity documents.)

U.S. CITIZENSHIP: We can accept most documents that show you were born in the U.S. If you
are a U.S. citizen born outside the U.S., show us a U.S. consular report of birth, a U.S. passport, a
Certificate of Citizenship, or a Certificate of Naturalization.

ALIEN STATUS: We need to see a current document issued to you by the U.S. Immigration and
Naturalization Service (INS), such as Form 1-551, 1-94, I-688B, or 1-766. We CANNOT accept a
receipt showing you applied for the document. If you are not authorized to work in the U.S., we can
issue you a Social Security card if you are lawfully here and need the number for a valid nonwork
reason. Your card will be marked to show you cannot work, and, if you do, we will notify INS.

IF YOU HAVE ANY QUESTIONS: If you have any questions about this form, or about the
documents you need to show us, please contact any Social Security office. A telephone call will help
you make sure you have everything you need to apply for a card.

THE PAPERWORK/PRIVACY ACT AND YOUR APPLICATION

The Privacy Act of 1974 requires us to give each person the following notice when applying for a
Social Security number.
Sections 205(c) and 702 of the Social Security Act allow us to collect the facts we ask for on this
form.
We use the facts you provide on this form to assign you a Social Security number and to issue you a
Social Security card. You do not have to give us these facts, however, without them we cannot issue
you a Social Security number or a card. Without a number, you may not be able to get a job and
could lose Social Security benefits in the future.
The Social Security number is also used by the Internal Revenue Service for tax administration
purposes as an identifier in processing tax returns of persons who have income which is reported to
the Internal Revenue Service and by persons who are claimed as dependents on someone's
Federal income tax return.
We may disclose information as necessary to administer Social Security programs, including to
appropriate law enforcement agencies to investigate alleged violations of Social Security law; to
other government agencies for administering entitlement, health, and welfare programs such as
Medicaid, Medicare, veterans benefits, military pension, and civil service annuities, black lung,
housing, student loans, railroad retirement benefits, and food stamps; to the Internal Revenue
Service for Federal tax administration; and to employers and former employers to properly prepare
wage reports. We may also disclose information as required by Federal law, for example, to the
Department of Justice, Immigration and Naturalization Service, to identify and locate aliens in the
U.S.; to the Selective Service System for draft registration; and to the Department of Health and

Form SS-5 Internet (2-98)

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Human Services for child support enforcement purposes. We may verify Social Security numbers for
State motor vehicle agencies that use the number in issuing drivers licenses, as authorized by the
Social Security Act. Finally, we may disclose information to your Congressional representative if they
request information to answer questions you ask him or her.
We may use the information you give us when we match records by computer. Matching programs
compare our records with those of other Federal, State, or local government agencies to determine
whether a person qualifies for benefits paid by the Federal government. The law allows us to do this
even if you do not agree to it.
Explanations about these and other reasons why information you provide us may be used or given
out are available in Social Security offices. If you want to learn more about this, contact any Social
Security office.
The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in

accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of
1995. We may not conduct or sponsor, and you are not required to respond to, a collection of
information unless it displays a valid OMB control number.
TIME IT TAKES TO COMPLETE THIS FORM

We estimate that it will take you about 8.5 to 9 minutes to provide the information. This includes the
time it will take to read the instructions, gather the necessary facts and provide the information. All
requests for Social Security cards and other claims-related information should be sent to your
local Social Security office, whose address is listed under Social Security Administration in the
U.S. Government section of your telephone directory. Comments or suggestions on our "Time it
Takes" estimate are welcome and should be addressed to: Social Security Administration, ATTN:
Reports Clearance Officer, 1-A-21 Operations Building, Baltimore, MD 21235-0001. SEND ONLY
COMMENTS ON OUR "TIME IT TAKES" ESTIMATE TO THIS ADDRESS.

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SOCIAL SECURITY ADMINISTRATION Application for a Social Security Card

First
Full Middle Name
NAME

Form Approved
OMB No. 0960-0066
Last

TO BE SHOWN ON CARD

FULL NAME AT BIRTH

IF OTHER THAN ABOVE

First

Full Middle Name

Last

OTHER NAMES USED

2
3
4

Street Address, Apt. No., PO Box, Rural Route No.

MAILING
ADDRESS

City

Do Not Abbreviate

CITIZENSHIP _____

State

Legal Alien

Asian AsianAmerican

Or

DATE
OF
BIRTH

Month, Day, Year

Black
(Not
Hispanic)

JJ

Hispanic

Pacific Islander

(Check One OnlyVoluntary)

Work
Female

U Male

RACE/ETHNIC
DESCRIPTION

Legal Alien

Other
U (See Instructions
On Page 1)

ElToNotWork
Allowed

p Allowed To

0 U.S. Citizen

(Check One)

SEX

Zip Code

White
(Not
Hispanic)

North
,--, American

LJ Indian or
Alaskan
Native

Office
Use
Only

PLACE OF
BIRTH

City

(Do Not Abbreviate)

A. MOTHER'S MAIDEN
NAME __________
8 B. MOTHER'S SOCIAL
SECURITY NUMBER _____

State or Foreign Country

Full Middle Name

First

(Complete only if applying for a number for a child under age 18.)
First

Full Middle Name

FCI
Last Name At Her Birth

Last

A. FATHER'S NAME
9 B. ___________________________ F
ATHER'S SOCIAL SECURITY
NUMBER ___________________
(Complete only if applying for a number for a child under age 18.)

Has the applicant or anyone acting on his/her behalf ever filed for or received a Social Security
number card before?
10
0 Yes (If "yes", answer questions 11-13.)

El No (If "no", go on to question 14.)

11Security number previously assigned to the person listed in item 1.Enter the
Enter the name shown on the most

First

12recent Social Security card issued for

15

Month, Day, Year

I - 1 g o on t o q u es t i on 1 4 )

Middle

Social

Last

t he pe rson l i st ed i n i te m 1 . -

Enter any different date of birth if used on an

earlier application for a card. __________

13
14 TODAY'S
DATE

r-1 Don't Know (If "don't know",

Month, Day, Year

DAYTIME
PHONE NUMBER

Area Code

Number

DELIBERATELY FURNISHING (OR CAUSING TO BE FURNISHED) FALSE INFORMATION ON THIS APPLICATION IS A CRIME PUNISHABLE BY FINE OR IMPRISONMENT, OR BOTH.

17

16 YOUR SIGNATURE
DO NOT WRITE BELOW THIS LINE (FOR SSA USE ONLY)
NPN
DOC
PBC

EVI

EVA

EVC

YOUR RELATIONSHIP TO THE PERSON IN ITEM 1 IS:

S e lf E l Na tu ra l or
Adoptive Parent

ri Legal
E l Othe r (Spec ify )
Guard ian ''

NTI

CAN

PRA

NWR

EVIDENCE SUBMITTED

ITV
DNR

UNIT

SIGNATURE AND TITLE OF EMPLOYEE(S) REVIEWING EVIDENCE AND/OR CONDUCTING INTERVIEW

DATE
DCL

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Page 5

DATE