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If you use extra help write extra help here and provide the details when you get to item 9. Form SSA-820-F4 2-1991 ef 12-2008 If you need more space for any answer use Page 3. Completed by CLAIMANT SSA REPRESENTATIVE OTHER 12. C. If Other show Name Address include ZIP code Phone Number include area code Relationship Interviewer/reviewer check list Yes answers should be developed in accordance with DI 13010ff. Rationalize Yes or No answers below except when it is necessary to complete the...
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