SSA-5-INST

Reporting Responsibilities For Mother's Or Father's Insurance Benefits

Download and Print the SSA-5-INST

CHANGES TO BE REPORTED AND HOW TO REPORT FAILURE TO REPORT MAY RESULT IN OVERPAYMENTS THAT MUST BE REPAID, AND IN POSSIBLE MONETARY PENALTIES

You change your mailing address for checks or residence. (To avoid delay in receipt of checks you should ALSO file a regular change of address notice with your post office.)

Your citizenship or immigration status changes.

You go outside the U.S.A. for 30 consecutive days or longer.

Any beneficiary dies or becomes unable to handle benefits.

Work Changes - On your application you told us you expect total earnings for to be $ .
You (are) (are not) earning wages of more than $ a month.
You (are) (are not) self-employed rendering substantial services in your trade or business.
(Report AT ONCE if this work pattern changes)

Change of Marital Status - Marriage, divorce, annulment of marriage. You must report marriage even if you believe that an exception applies.

Custody Change or Disability Improves - Report if a person for whom you are filing, or who is in your care dies, leaves your care or custody, changes address, or, if disabled, the condition improves.

You are confined to jail, prison, penal institution or correctional facility for conviction of a crime or you are confined to a public institution by court order in connection with a crime.

And much more...