SSA-3885 2011 free printable template

Form Approved OMB No. 0960-0160 SOCIAL SECURITY ADMINISTRATION GOVERNMENT PENSION QUESTIONNAIRE NAME OF WAGE EARNER OF SELF-EMPLOYED PERSON NAME OF PERSON MAKING STATEMENT If other than wage earner or self-employed person RELATIONSHIP TO WAGE EARNER OR SELF-EMPLOYED PERSON Privacy Act Statement Government Pension Questionnaire - Section 202 of the Social Security Act 42 U.S.C. C When could you have first received this pension/annuity DAY Local b On the date shown in a above was this...

How to fill out SSA-3885

How to fill out SSA-3885

1. Start with your personal information at the top of the form, including your name, Social Security number, and date of birth.
2. In Section 1, indicate whether you are applying for disability benefits, Supplemental Security Income (SSI), or both.
3. In Section 2, provide details about your medical condition, including the onset date and any relevant diagnoses.
4. Fill out Section 3 with your employment history, listing all jobs you've held in the past 15 years, including job titles and duties.
5. Section 4 requires you to list any treatments, medications, and therapy you have received related to your condition.
6. Complete Section 5 regarding your daily activities and how your condition affects your ability to perform them.
7. Review your answers for accuracy before signing and dating the form at the bottom.
8. Submit the completed SSA-3885 form to your local Social Security Administration office.

Who needs SSA-3885?

1. Individuals applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
2. Those who have a medical condition that significantly impairs their ability to work and perform daily activities.
3. Applicants who need to provide comprehensive information about their disability and its impact on their lives.

People Also Ask about

What is the form for Social Security pension?

Form SSA-1 | Information You Need To Apply For Retirement Benefits Or Medicare. You can apply: Online; or. By calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or visiting your local Social Security office.

What is Form SSA 3885 used for?

Regardless of the timing, at some point the applicants or beneficiaries must complete and sign Form SSA-3885 to report information about their government pensions before the pensions begin.

Why was I denied Social Security retirement benefits?

Here are some of the most common reasons for a denial of Social Security benefits: Your monthly income exceeds $940. Your disability will last less than a year. You failed to heed your doctor's instructions.

What is the 5 year rule for Social Security disability?

No waiting period is required if you were previously entitled to disability benefits or to a period of disability under § 404.320 any time within 5 years of the month you again became disabled.

What is Form SSA 150?

SSA collects information on the SSA 150 to determine the correct formula to use in computing the Social Security benefit for someone who receives a pension from employment not covered by Social Security.

What is a modified benefit formula for Social Security?

A modified benefit formula is used to compute Social Security benefits for persons entitled to both a pension or annuity based on employment after 1956 not covered by Social Security and a Social Security retirement or disability insurance benefit.

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What is SSA-3885?

SSA-3885 is a form used by the Social Security Administration (SSA) for individuals to report the existence of self-employment income, which may affect their eligibility for Social Security benefits.

Who is required to file SSA-3885?

Individuals who receive Social Security benefits and have self-employment income must file SSA-3885 to ensure proper reporting of their earnings.

How to fill out SSA-3885?

To fill out SSA-3885, individuals should provide their personal information, details of self-employment, income figures, and any relevant business expenses on the form according to the instructions provided with it.

What is the purpose of SSA-3885?

The purpose of SSA-3885 is to collect information regarding self-employment income to accurately assess Social Security benefits and ensure compliance with reporting requirements.

What information must be reported on SSA-3885?

The information that must be reported on SSA-3885 includes personal identification information, details of the self-employment business, gross income, business expenses, and net profit or loss from self-employment.