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Gibbons Family Medicine Medical Release of Information Form Patient Name: Date of Birth: Social Security #: Previous Name: Home Phone: Other Phone: Address, City, State, Zip: Fax: I request and authorize
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How to fill out social security previous name

How to fill out social security previous name:
01
Locate the appropriate form: To update your social security previous name, you will need to fill out Form SS-5, Application for a Social Security Card. This can be obtained online through the official Social Security Administration (SSA) website or by visiting your local SSA office.
02
Provide necessary information: On the SS-5 form, you will be required to provide your full name, social security number, date of birth, and contact information. In the section specifically for previous names, you will need to accurately enter the name(s) you were previously known as.
03
Document your name change: In case your previous name was different from your current name due to marriage, divorce, or other legal reasons, you will need to submit supporting documents with your application. Examples of acceptable documents include a marriage certificate, divorce decree, or court-issued name change document.
04
Submit your application: Once you have completed the SS-5 form and gathered the necessary documents, you can submit your application either online or by mail, as instructed by the SSA. Make sure to keep a copy of the completed form for your records.
Who needs social security previous name:
01
Individuals who have changed their name: If you have legally changed your name in the past due to marriage, divorce, or any other reason, you will need to provide your social security previous name when updating your records with the SSA.
02
Recent immigrants or naturalized citizens: If you have recently immigrated to the United States or have become a naturalized citizen, you may also need to provide your social security previous name if you had a different name before coming to the country.
03
Individuals with errors on their social security record: In some cases, there may be errors or discrepancies on your social security record, such as misspellings or incorrect names. By providing your social security previous name, you can help the SSA correct any inaccuracies and ensure your record is up to date.
04
Beneficiaries of deceased individuals: If you are the surviving spouse or dependent of a deceased person who had a different name while they were alive, you may be required to provide their social security previous name when handling their social security benefits or related matters.
Note: It is always recommended to consult the official Social Security Administration website or contact your local SSA office for the most accurate and updated information regarding filling out forms and providing required documentation.
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What is social security previous name?
Social security previous name was known as the Old Age, Survivors, and Disability Insurance (OASDI) program.
Who is required to file social security previous name?
Individuals who have legally changed their name and need to notify the Social Security Administration.
How to fill out social security previous name?
The individual can fill out the Social Security Administration's Name Change Request Form and submit it with supporting documentation.
What is the purpose of social security previous name?
The purpose is to update the individual's record with the correct name to ensure accurate benefits and records.
What information must be reported on social security previous name?
The individual must report their previous name, new name, Social Security number, and supporting documentation of the name change.
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