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Sections (c) and of the Social Security Act allow us to collect the facts we ask for on this form. We use the facts you provide on this form to assign you a Social Security number and to issue you a Social Security card. You do not have to give us these facts, however, without them we cannot issue you a Social Security number or a card. After you download the Adobe Acrobat Reader, come back to this page and download the PDF version of the SSAU2 below. Remember to enable the "Load to Disk" capability of your WWW browser prior to downloading the SSAU2 in either PDF format. PDF files are printer independent and should print easily on any graphics printer (i.e., laser. Form SSABK () ef () Page 2 2. Frequently lift and/or carry (including upward pulling) (maximum) - when less than two-thirds of the time or less than 10 pounds, explain the amount (time/pounds) in item 6. 3. Stand and/or walk (with normal breaks) for a total of - 5. Push and/or pull (including operation of hand and/or foot.

Sections (c) and of the Social Security Act allow us to collect the facts we ask for on this form. We use the facts you provide on this form to assign you a Social Security number and to issue you a Social Security card. You do not have to give us these facts, however, without them we cannot issue you a Social Security number or a card. Sections (a) and (e)(1)(A) and (B) of the Social Security Act, as amended, and Social Security regulations at 20 C.F.R. and authorize us to collect this information. We will use the information you provide to further document your claim and permit a. After you download the Adobe Acrobat Reader, come back to this page and download the PDF version of the SSAU2 below. Remember to enable the "Load to Disk" capability of your WWW browser prior to downloading the SSAU2 in either PDF format. PDF files are printer independent and should print easily on any graphics printer (i.e., laser.

SSA Forms - General. These forms can be used for both Adult SSI/SSDI and Child SSI Applications. SSA Consent for Release of Information (PDF) SSA Authorization to Disclose Information to SSA (PDF) SSA Appointment of Representative (PDF) SSA Application for Supplemental Security Income (SSI) (PDF) SOAR TA Center Tool. Site-Specific Data Item (SSDI) Manual. Effective with Cases Diagnosed 1/1/ and Forward. Published (September ) Version Editors: Jennifer Ruhl, MSHCA, RHIT, CCS, CTR, NCI SEER. Form SSABK () UF Discontinue Prior Editions Social Security Administration. Page 1 of 15 OMB No. CONTINUING DISABILITY REVIEW REPORT. PLEASE READ THIS INFORMATION BEFORE COMPLETING THIS REPORT.