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SSA Form SSA-159 2010 free printable template

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Attachment 2 Form Approved OMB No 0960-0757 Social Security Administration GSO Website Registration Form Complete the following information to obtain access to GSO services.
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How to fill out SSA Form SSA-159

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How to fill out SSA Form SSA-159

01
Obtain the SSA Form SSA-159 from the Social Security Administration website or your local SSA office.
02
Fill in your personal information, including your name, address, Social Security number, and phone number.
03
Indicate the type of service you are providing or requesting compensation for in the designated section.
04
If applicable, include the date of service and the total amount of fees charged.
05
Sign and date the form in the appropriate section.
06
Review the form for accuracy and completeness before submitting.
07
Submit the completed form to the appropriate SSA office or the individual requesting the form.

Who needs SSA Form SSA-159?

01
Individuals or service providers who are seeking reimbursement for services rendered to clients under the Social Security program.
02
Medical professionals providing services that are reimbursable through Social Security.
03
Legal professionals who may require compensation for representing clients in Social Security matters.
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SSA Form SSA-159 is a form used by the Social Security Administration (SSA) to report fees charged by representatives for services provided to claimants.
Individuals or entities that represent claimants in dealings with the SSA and charge a fee for their services are required to file SSA Form SSA-159.
To fill out SSA Form SSA-159, a representative needs to provide their personal information, the claimant's information, details about the services provided, the fee charged, and sign the form to certify that the information is accurate.
The purpose of SSA Form SSA-159 is to document the fees charged by representatives for assistance with Social Security claims, ensuring transparency and compliance with SSA fee regulations.
SSA Form SSA-159 must report the representative's name, address, and identification number, as well as the claimant's details, a description of services provided, the total fee amount, and the representative's signature.
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