Item 1—“Unit No.”
Enter “Mod 7” or “Mod 8” in this block.
Enter the date the SSA-790-RR is prepared.
Item 3—“Name of RR Employee”
Enter the first name, middle initial and last name of the number holder and also
his/her name as shown on the SSN card if different.
Item 4—“SSA Account Number”
Enter all known SSNs for the number holder.
Item 5—“RRB Claim Number”
Insert the RRB claim number, if available; otherwise, do not write in this space
because RRB will enter its claim number, if any.
Item 6—“Type of Action”
Check one box to indicate the type of claim currently being processed or to indicate
that the RRB ER is needed to answer an inquiry.
Item 7—“Date of Death”
For survivor cases, enter the number holder's date of death. If the exact date is
unknown, enter the approximate date as accurately as possible.
Item 8—“Date of Birth”
Enter the number holder's date of birth.
Item 9—“Date of Onset”
For disability cases, enter the month and year that the number holder's alleged
present disability began.
Item 10—“Furnish Information as Indicated Below”
Check block B and line-out the phrase “on attached RR-90”.
Check block C and line-out the phrase “on attached RR-90”. If the years are known, they should be entered in the block provided.