Download Form SSA-827 Authorization to Disclose Information to the Social Security Administration
Form SSA-827 Instructions
The instructions for completing the form are provided on Form SSA-827-INST, Instructions for Completing the SSA-827 and down below.
You have a right to withdraw your authorization at any time. To do so, send or bring your written statement to the nearest Social Security office. Send one more copy directly to the source you want to stop disclosing your personal information. The SSA has the right to use the information received before revocation to make decision on your benefit claim. If not revoked, the authorization provided by the form is valid for 12 months from the date signed.
The SSA policy includes providing services to people with limited English proficiency on the language they prefer. Inform your local SSA office about the case, and the SSA officials will make every reasonable effort to provide you the information about the SSA Form 827 in the language you prefer.
How to Fill out Form SSA-827?
- Provide the first, middle, last name, suffix, date of birth, and Social Security number of the individual whose records to be disclosed;
- Read carefully both pages of the form before signing it;
- If the SSA only determines whether you can manage your benefits, check the applicable box in the section "Purpose";
- Sign the form using only blue or black ink;
- If you are not the subject of disclosure, specify your authority by checking the appropriate box; if you are a personal representative rather than a parent or guardian of minor, explain your relationship to the claimant in the space provided under the checkbox; note, that representative payees and appointed representatives are not allowed to sign the SSA authorization to disclosure information form;
- Date the form;
- Provide your contact information in the applicable boxes: telephone number with area code, street address, city, state, and ZIP code.
- The "Witness" section is optional. The federal laws do not require the verification of your identity with witnesses' signatures. However, the witness' signature may be required by the state law. Moreover, the form must contain the witness's signature if you sign your authorization with mark "X". In this case, the person who knows the individual signing the form or is satisfied with the individual's identity has to sign in the appropriate box and provide either mailing address or phone number.
Form SSA-827 - Which States Need Second Witness Signature?
The SSA Authorization to Disclose Information includes space for a second witness's signature and contacts. The following states require that any documents being recorded within these states must be testified with two witnesses:
- South Carolina.
Where to Mail Form SSA-827?
Mail or take the completed form to the local Social Security office. Specify the address of your local office on the SSA website, in your telephone directory under the U.S. Government agencies, or by calling a toll-free number provided on the second page of the form. The SSA accepts pen and ink signed forms by fax too.