The individual must answer yes to all of the requirements above (i.e., intent to provide
information, truthfulness of it, and agreement to sign it under penalty of perjury)
in order to accept the form as a signed form. Individuals answering no to any of the
requirements will need to submit the form with a pen-and-ink signature.
Follow the procedure below to document that you attest to the claimants agreement
to all requirements and signing of the form:
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Annotate the forms signature field with the following: the individuals name and Attested
by (your full name). Office code: (your office code).
Reminder for the SSA-21: The signature block in item 18 of the form will need to be annotated for each beneficiary listed in item 3 of the form.
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•
Fax actionable forms to the Division of International Operations (DIO) Paperless.
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•
Store non-actionable forms in the Evidence Portal (EP). For an overview of the EP,
see MS 09701.001.
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•
For the SSA-7161 and SSA-7162: Send the completed form to Wilkes-Barre Direct Operations Center(WBDOC) via the multifunction
device (MFD) process. If the FEQ to WBDOC button is unavailable on the MFD, e-fax
the completed form to WBDOC FEQ Scan Only eFax inbox.
IMPORTANT: Refer to the Electronic Disability Guide (eDG), DI 81000.000for operational procedures
specific to updating the Certified Electronic Folder.
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•
Issue the Document Processing System (DPS) "Attestation Cover letter" with a copy
of the completed form to the respondent.