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Get Form Ssa 89 2023-2024

Printed Name: Date of Birth: Social Security Number: Reason for authorizing consent: (Please select one) To apply for a mortgage To apply for a loan To meet a licensing requirement To open a bank account To open a retirement account Other To apply for a credit card To apply for a job With the following company ("the Company"): Company Name: Company Address: The name and address of the Company's Agent (if applicable): Agent's Name: Agent's Address: I authorize the Social Security Admin.

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