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2. Function Report- Adult - The United States Social Security...

   www.ssa.gov/forms/ssa-3373-bk.pdf

   complete the form. If you need the address or phone number for the office that provided the form, you can get it by calling Social Security at 1-800-772-1213. HOW TO COMPLETE THIS FORM. The information that you give us on this form will be used by the office that makes the disability decision on your disability claim.

3. Social Security Forms | SSA

   www.ssa.gov/forms

   Forms. All forms are FREE. Not all forms are listed. If you can't find the form you need, or you need help completing a form, please call us at 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office and we will help you.

4. DI 11005.026 Completing the SSA-3373-BK (Function Report – Adult)

   secure.ssa.gov/poms.nsf/lnx/0411005026

   A. Policy. Use the SSA-3373 to collect information about a claimant's ability to function and to perform the activities of daily living.The information detailed on the SSA-3373 may be obtained by telephone and recorded on an SSA-5002 in lieu of using the SSA-3373.

5. SSA - POMS: DI 11005.016 - Forms Used in Title II & Title XVI...

   secure.ssa.gov/poms.nsf/lnx/0411005016

   The SSA-3373 records information about a claimant's ability to function and to perform the activities of daily living, in the circumstances listed in DI 11005.026. The SSA-3373 is not mandatory in all cases (for example, listing-level impairments).

6. SSA-3369-BK - Work History Report

   www.ssa.gov/forms/ssa-3369.pdf

   WHAT YOU NEED TO COMPLETE THIS REPORT. Information about all the jobs that you had in the last 5 years before you became unable to work. ANSWER EVERY QUESTION FOR EACH JOB YOU DESCRIBE unless the report indicates otherwise. Provide as much detail as possible.

7. FUNCTION REPORT - ADULT - THIRD PARTY Form SSA-3380-BK

   www.ssa.gov/forms/ssa-3380.pdf

   The information that you give on this form will be used to make a decision on the disabled person's claim. You can help by completing as much of the form as you can.

8. Available Language Resources | SSA

   www.ssa.gov/multilanguage

   Explore Social Security Administration (SSA) programs and benefits, information about Free Interpreter Services, Social Security Statement, Fact Sheets, and SSA publications in different languages.

9. SSA - POMS: DI 20502.015 - Documents for Initial Disability Cases...

   secure.ssa.gov/poms.nsf/lnx/0420502015

   The specific form to be completed is dictated by the age of the child at the time of completion (or if mailed, age at the time the form is mailed to the applicant). The form records information on functional abilities.

10. Function Report - Child Age 3 to 6th Birthday - The United States...

    www.ssa.gov/forms/ssa-3377-bk.pdf

    IF YOU NEED HELP COMPLETING ANY PART OF THIS FORM, CONTACT YOUR SOCIAL SECURITY OFFICE. WE WILL HELP YOU. The information that you give us on this form will be used by the office that makes the disability decision on the child's claim. You can help them by completing as much of the form as you can. Print or type.

11. Function Report - Child Age 12 to 18th Birthday

    www.ssa.gov/forms/ssa-3379-bk.pdf

    The information that you give us on this form will be used by the office that makes the disability decision on the child's claim. You can help them by completing as much of the form as you can.