This form is used to establish a date on which a claimant's eligibility for benefit payments is determined (sometimes called the protective filing date). An application must be filed with the Social Security Administration before one can be entitled to Social Security payments or Supplemental Security Income (SSI). A letter, filed with the SSA, may serve as an application if all of the necessary requirements are met.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.Omaha Nebraska Carta o declaración a la Administración del Seguro Social para establecer la fecha de elegibilidad para los beneficios del reclamante - Letter or Statement to Social Security Administration in Order to Establish Claimant's Date of Eligibility for Benefits
State:
Multi-State
City:
Omaha
Control #:
US-01279BG
Format:
Word
Instant download
