SSA-3373 (Formerly SSA-3373-BK) 2020 free printable template

Form SSA3373 (062020) Discontinue Prior Editions Social Security Administration Page 1 of 10 OMB No. 09600681FUNCTION REPORT ADULT READ ALL OF THIS INFORMATION BEFORE YOU BEGIN COMPLETING THIS FORM

How to fill out SSA-3373 Formerly SSA-3373-BK

How to fill out SSA-3373 (Formerly SSA-3373-BK)

1. Begin by downloading the SSA-3373 form from the Social Security Administration website.
2. Read the instructions on the first page carefully.
3. Fill in your personal information including your name, Social Security number, and date of birth in the designated areas.
4. Provide detailed information about your medical conditions and how they affect your daily life.
5. Describe your work history and any past jobs, including the dates of employment and the nature of the work performed.
6. Include contact information for any healthcare providers that have treated you.
7. Review your responses for accuracy and completeness before signing the form.
8. Submit the completed form to your local Social Security office, either by mail or in person.

Who needs SSA-3373 (Formerly SSA-3373-BK)?

1. The SSA-3373 form is needed by individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) who are required to provide information about their disability and its impact on their ability to work.

• Who needs an SSA-3373-BK Form?
• What is an SSA-3373-BK Form Used for?
• Is an SSA-3373-BK Form Accompanied by Other Forms?
• • What Information Should be Provided in an SSA-3373-BK Form?
  • How do I fill out an SSA-3373-BK Form?
  • Where do I send an SSA-3373-BK Form?

Who needs an SSA-3373-BK Form?

People who want to report their illnesses, conditions or injuries limiting their lives should use this form.

What is an SSA-3373-BK Form Used for?

This form is an essential paper while applying for any kind of benefits from the employer or government. While asking for some aid you will automatically explain how your life is limited and how the requested benefit can help you.

Is an SSA-3373-BK Form Accompanied by Other Forms?

An SSA-3373-BK Form is not accompanied by other forms. It doesn't need any attachments as well. If you lack some space while answering some questions you can use a “REMARKS” section on the leis page of the form.

What Information Should be Provided in an SSA-3373-BK Form?

• Disabled person's name

• Social Security Number

• Phone number

• Habitation information

• How do reported circumstances limit your ability to work

• Information about daily activities

• Information about abilities

• Medicines taken

• Etc

How do I fill out an SSA-3373-BK Form?

You shouldn't leave fields blank. If you are not sure about the answer you should either call a Social Security and ask them for help or simply write “Don't know”. This form doesn't require any special knowledge. This is made for you to fill it out on your own. If either the explanation is asked for or you need to explain the answer, be sure to explain the answer. If you need some more space to answer any question, there's “REMARKS” section on the last page for it. Don't forget to write the number of question being answered while using the “REMARKS” section.
Don't write on the “For SSA Use Only” section.

Where do I send an SSA-3373-BK Form?

It is sent to the establishment which made a request for it.

Instructions and Help about SSA-3373 Formerly SSA-3373-BK

2015 annual state of corruption report the cost of corruption on the economy politics and service delivery in Zimbabwe 2002 2015 corruption in Zimbabwe is a topical developmental economic and governance policy issue it is directly related to key challenges that Zimbabwe continues to face these challenges include unemployment poverty capital flight deindustrialization low investment rates poor social service delivery political anger violence and civic protest this presentation introduces you to the findings of the 2015 annual state of corruption report by Transparency International Zimbabwe the report entitled political economy of corruption and the battle for accountability in Zimbabwe explored the cumulative cost of corruption on three key governance sectors economics politics social service delivery from the year 2000 to 2015 the Shone a Dodge woodsy another era para SU girl meaning a goat grazes from where it is tied has become everyday language corruption in Zimbabwe has reached endemic levels Zimbabwe continues to score badly on the corruption perception index and in comparison to its neighbors such as Botswana in 2014 the national corruption barometer x TI Zed and the 2015 Afro barometer corroborated that corruption is on the increase in Zimbabwe a majority of citizens in the range of 68 to 70 four percent in Zimbabwe believe that corruption is on the increase with bribery being the common form of corruption that citizens experience and relate to within their day-to-day lives when interacting with public institutions Zimbabwe also performs well below the regional average on the 2015 Heritage Foundation index of economic freedom especially in terms of freedom from corruption ranking at 21 out of 100 and is placed at the bottom of the regional rankings the country also performs extremely poorly in all six governance areas assessed by the 2013 World Bank worldwide governance indicators scoring 2.87 on a 0-200 scale in terms of freedom from corruption 2.37 in terms of rule of law 2.39 in terms of regulatory quality 12.9 to in terms of government effectiveness 9.95 in terms of voice and accountability and finally 24 point 17 in terms of political stability and absence of violence the most prevalent forms of corruption in Zimbabwe are at the grand and petty levels grand corruption typically takes place at the top levels of the public sphere and the senior management levels in business where policies and rules are formulated and executive decisions are made it also often involves large sums of money the majority of perpetrators of grand corruption in Zimbabwe are political actors with political backing and influence grand corruption is best understood from the context of factional and predatory politics due to factional fighting in Zimbabwe's ruling party Zanuck a series of scandals have been exposed by political players to discredit one another these scandals and allegations have only surfaced as a result of political infighting in most of the...

People Also Ask about

How long do you have to report address change to Social Security?

WHEN DO YOU NEED TO REPORT? Report any changes that may affect your SSI as soon as possible and no later than 10 days after the end of the month in which the change occurred.

How do I notify Social Security that I have moved?

Change of Address Log in to my Social Security. Select the My Profile tab. Select the Contact link to enter and update your address and phone information. Select when would you like to schedule the update, then select Continue. Review and verify your information, select Submit.

Can I fill out the SS 5 form online?

The form you are looking for is not available online. Many forms must be completed only by a Social Security Representative. Please call us at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday between 8 a.m. and 5:30 p.m. or contact your local Social Security office.

How do I report to Social Security that I moved?

You can report your change online, or by calling toll free at 1-800-772-1213. If you're deaf or hearing-impaired call TTY 1-800-325-0778. Mail the information to your local Social Security office or in person if you prefer.

How do I change my address with SSA?

If you get Social Security benefits (retirement, survivors, or disability) or are enrolled in Medicare, you can change your address or direct deposit information online using the My Profile tab in your personal my Social Security account. You can also decide when the change will take effect.

What is an SSA 44 form?

Fill out the Medicare Income-Related Monthly Adjustment Amount-Life-changing Event (SSA-44) (PDF) form. Fax or mail your completed form and evidence to a Social Security office.

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What is SSA-3373 (Formerly SSA-3373-BK)?

SSA-3373 is a form used by the Social Security Administration (SSA) to collect information from individuals seeking disability benefits regarding their functional limitations due to their medical conditions.

Who is required to file SSA-3373 (Formerly SSA-3373-BK)?

Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits may be required to file SSA-3373 to provide detailed information about their daily activities and functional capabilities.

How to fill out SSA-3373 (Formerly SSA-3373-BK)?

To fill out SSA-3373, applicants should complete the sections detailing their medical conditions, describe how these conditions affect their daily activities, and provide examples of their limitations. It is also important to be thorough and honest in describing the impact on their ability to work.

What is the purpose of SSA-3373 (Formerly SSA-3373-BK)?

The purpose of SSA-3373 is to gather comprehensive information about an applicant's functional capabilities and limitations, helping the SSA assess whether the applicant qualifies for disability benefits.

What information must be reported on SSA-3373 (Formerly SSA-3373-BK)?

Applicants must report information regarding their medical conditions, how these conditions affect their ability to carry out daily activities, their work history, and any treatments or therapies they are undergoing.