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SSA-25

Certification Of Election For  Reduced Spouse's Benefits

Download and Print the SSA-25

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

1. PRINT NAME OF WAGE EARNER OR SELF-EMPLOYED PERSON (Hereafter called "Worker")
ENTER HIS OR HER SOCIAL SECURITY NUMBER

2. PRINT YOUR FULL NAME (First name, middle initial, last name)
ENTER YOUR SOCIAL SECURITY NUMBER (If "none" or "unknown" so indicate.)

A spouse's insurance benefit may be payable for months between age 62 and full retirement age (FRA), even if you do not have in your care a child of the worker under age 16 or disabled entitled to a child's insurance benefit.

Choosing to receive spouse's insurance benefits before FRA will result in a permanent reduction in your monthly benefits.

Since such benefit will be at a permanently reduced rate and will continue at a permanently reduced rate even after FRA, the law requires that we obtain a certificate of election if you wish to receive the permanently reduced benefit.

The amount of the reduction is 25/36 of 1 percent for each of the first 36 months from the start of the permanently reduced benefits to, but not including, the month you reach FRA.

The reduction is 5/12 of 1 percent for each such month in excess of 36. In addition, if another beneficiary(ies) other than the wage earner (e.g., a student child beneficiary) is entitled to a monthly benefit on this Social Security number, election for a reduced spouse's benefit may cause a reduction in total monthly benefits.

These reduced benefits may be paid for as many as 12 months before the month this certificate is filed. No reduced spouse's benefit may begin before the month you are 62. If you are eligible for retirement insurance benefits in the month this certificate takes effect, you will be considered to have applied for them.

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