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Social Security 1099 Form
7. Address
12/1/05 5:40 PM Page
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12/1/05 5:40 PM Page
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Form SSA-1099-SM (1-2017)
Box 8. Claim Number (Use this number if you need to contact SSA.)
DO NOT RETURN THIS FORM TO SSA OR IRS
IMPORTANT: TAX INFORMATION ENCLOSED
KEEP THIS FORM FOR PROOF OF SOCIAL SECURITY BENEFITS
VISIT OUR WEBSITE WWW.SOCIALSECURITY.GOV
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Printed on recycled paper
U.S. GOVERNMENT PUBLISHING OFFICE: 2017-398-203/60003
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Form SSA-1099-SM (1-2017)
OFFICIAL BUSINESS
PENALTY FOR PRIVATE USE, $300
FIRST-CLASS...
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