Transcription of APPLICATION FOR SUPPLEMENTAL SECURITY …
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APPLICATION FOR SUPPLEMENTAL SECURITY …
FORM APPROVED SOCIAL SECURITY ADMINISTRATION TEL OMB NO. 0960-0444 Form SSA-8001-F5 (12-2002) Page 1 APPLICATION FOR SUPPLEMENTAL SECURITY INCOME Do not write in this space. I am/We are applying for SUPPLEMENTAL SECURITY Income and any federally administered State supplementation under title XVI of the Social SECURITY Act, for benefits under the other programs administered by the Social SECURITY Administration, and where applicable, for medical assistance under title XIX of the Social SECURITY Act.
Form SSA-8001-F5 (12-2002) Page 3 PART V – FOOD STAMPS 19. Are you currently receiving food stamps or has a food stamp application been filed for you within the past 60 days on which
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Subject: Annual ODWC Rehabilitator Permit, Commercial, Application, Federal Migratory Bird Rehabilitation permit, Rehabilitation, ORDER FORM INSTRUCTIONS FAST PACKAGE, Application for UI & DI Elective, Elective coverage for employees excluded, National Park Service, Historic Preservation Tax Incentives