TN 22 (08-06)

GN 00301.400 Extract Translations

A. Policy

Only authorized SSA translators can prepare extract translations.

1. Prescribed Forms

The prescribed forms are as follows:

  • Form SSA-533 (Translation Request). Translate all required information on the reverse (translation) side.

  • Form SSA-704 (Certification of Contents of Documents or Records).

  • SSA-4385 (Certification of Contents of Court Records) in accordance with instructions in GN 00301.115E.

  • The EVID screen, the “RPOC” screen in MCS, or the “DROC” screen for MSSICS claims in PE situations. (See GN 00301.286, GN 00301.287, and GN 00301.288)

2. “Translation Stamp”

A “translation stamp” can be used as an alternative method of documenting a translation. Translate pertinent data from commonly presented proofs (e.g., birth and baptismal certificates, death and marriage certificates) on reverse side of SSA's retained photocopy of the foreign- language document. The format may be stamped or handwritten. See the exhibit in GN 00301.400B.

B. Exhibit - Extract Translation Stamp Format

EXTRACT TRANSLATION STAMP

 

CLAIM NO. _________________________________________

 

 

THIS IS A B/C  ___   BAPT/C ____   D/C ____ M/C _____    OTHER ______

 

DOCUMENT RELATES TO:

BIC ______   NAME ____________    SSN:_____________   AGE ___________     

 

(IF MARRIAGE CERTIFICATE) SPOUSE'S NAME: ___________________  AGE   ________

 

(IF POA) FATHER: ________________________  MOTHER:    ____________________________

 

DATE OF EVENT/BIRTH   ______________________________

 

PLACE OF EVENT/BIRTH   __________________________________________

 

NAME OF OFFICIATING PRIEST (IF MEXICAN BAPTISMAL CERTIFICATE)

_______________________________________________________________________

 

DATE OF RECORDATION         _______________________________             

 

ISSUING AGENCY        ________________________________________________                                  

 

DATE ISSUED      ________________________________________________                  

 

THE ORIGINAL, OF WHICH THIS IS A PHOTOCOPY, APPEARS TO BE GENUINE, UNALTERED, AND TO HAVE BEEN MADE AT THE TIME PURPORTED.

 

TRANSLATOR'S SIGNATURE:  ________________________________   TITLE   _________  

 

DATE DOCUMENT TRANSLATED  _____________________________________               


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200301400
GN 00301.400 - Extract Translations - 06/05/2007
Batch run: 01/27/2009
Rev:06/05/2007