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Fillable Request for Reconsideration ( SSA - 561 ) - Social Security - ssa

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SOCIAL SECURITY ADMINISTRATION TOE 710 Form Approved OMB No. 0960-0622 REQUEST FOR RECONSIDERATION NAME OF CLAIMANT NAME OF WAGE EARNER OR SELF-EMPLOYED PERSON (If different from claimant.) (Do not write in this space) CLAIMANT SSN CLAIMANT CLAIM NUMBER (if different from SSN) - - - - SUPPLEMENTAL SECURITY INCOME (SSI) OR SPECIAL VETERANS BENEFITS (SVB) CLAIM NUMBER - - SPOUSE'S NAME (Complete ONLY...
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