Fillable withdrawal form 2012

Description
Give reason for withdrawal. If you need more space use the reverse of this form. I intend to continue working. SOCIAL SECURITY ADMINISTRATION Form Approved OMB No. 0960-0015 TOE 420 REQUEST FOR WITHDRAWAL OF APPLICATION Do not write in this space IMPORTANT NOTICE - This is a request to cancel your application. If we approve it the decision we made on your application will have no legal effect. 1. Signature of...
Fill & Sign Online, Print, Email, Fax, or Download
  • Fill Online
  • eSign
  • eFax
  • Email
  • Add Annotations
  • Share
Fill & Sign Online, Print, Email, Fax, or Download
Fill Online
Advertisement