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Application For Special Benefits For World War 2 Veterans

Download and Print the SSA-2000

Request may not be processed if the form is incomplete or illegible.

I am applying for all benefits for which I am eligible under title VIII (Special Benefits for Certain World War II Veterans) of the Social Security Act, and for benefits under other programs administered by the Social Security Administration.
FILING DATE - Month, Day, Year - Actual or Protective

1. (a) Print your name
First Name, Middle Initial, Last Name

(b) Enter your date of birth
Month Day Year

2. (a) Enter your Social Security Number
— — — / — — / — — — —

(b) Did you ever use any other names (including maiden name) or other Social Security Numbers (SSN)?
(c) Other Names or SSNs Used

3. Sex - male - female

4. (a) Have you (or has someone on your behalf) ever filed an application for Supplemental Security Income (SSI)?
Yes - No

(b) Are you currently receiving SSI payments?  Yes- - No
If “NO,” when did you last receive SSI payments?
Month - Year
(a) Were you in the active military, naval or air service of the United States after September 15, 1940 and before July 25, 1947?   Yes - No
(b) Enter dates of service.

And much more...