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Get and Sign Ssa 16 Bk Form 2018
If English is not your preferred language. Otherwise, go to item 5.
4.
5.
Enter the language you prefer to:
Speak
(a) Enter your date of birth
Write
MONTH, DAY, YEAR
(b) Enter name of city and state or foreign country where you
were born.
(c) Was a public record of your birth made before you were age 5?
No
Unknown
(d) Was a religious record of your birth made before you were age 5?
6.
Yes
Yes
No
Unknown
(a) Are you a U.S. citizen?
Yes
Go to item 7
No
Go to item (b)
(b) Are you an...
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