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I authorize the Social Security Administration to release information or records about me to: *NAME OF ... If you want us to release a minor child×39’s medical records, do not use this form. Instead
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Signifies A is a form used to indicate a specific action or characteristic.
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The purpose of Signifies A is to track and record important actions or characteristics.
The information reported on Signifies A includes the specific action or characteristic being indicated.
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