How to Fill out Form SSA-623?
Complete and submit the form within 30 days after receiving it. Use black ink when filling out the document. Do not use the dollar sign and show all required amounts in dollars only (do not enter cents).
The instructions are as follows:
- Indicate if you were convicted of a felony during the reporting period. If yes, provide the type of crime in "Remarks" box;
- Answer "Yes" to question 2 if the beneficiary continued to live with the same person, in the same institution or alone during the reporting period. If during any part of this period other people or institutions took care of the beneficiary, answer "No" and comment in the "Remarks" box;
- Provide the details on the accounting for beneficiary for the reporting period. Include total accountable amount, food, housing, and personal items expenses. Enter the total amount of unused benefits, if any. If you did not save any benefits, enter "0". Indicate who decided how to use benefits. If it were not you, provide the explanations in the "Remark" box;
- Fill out question 4 only if you showed an amount in question 3D. Indicate the account type and title;
- If you checked "Other" in question 4A or B, provide the details in question 5;
- Sign your name. If you sign with "X", you must have two witnesses to sign too. If the payee is an organization, the document must be signed by an authorized representative only;
- Enter the date;
- Indicate your daytime phone number.
You will receive the detailed instruction and all completion requirements with the form you must complete. If you need any help with the document, contact the local Social Security office.
Where to Mail Form SSA-623-F6?
The SSA sends an envelope with an enclosed Form SSA-623-F6. Place your completed form in the envelope and return it to the SSA office indicated on the form. Do not include any records like checks or receipts. However, keep them for two years from the date you filed the form. If the SSA requires a proof, they will notify you.
You can also submit the form online. The link will be provided with the form. In this case, you can print a copy of your report after completion. You do not need to submit a paper version of Form SSA-623, if you filled out an electronic one.