Effective Dates: 03/08/1995 - Present Previous | Next

Basic (03-95)

GN 03950.070 Exhibit - Example of SSA-795, Statement of Claimant or Other Person (For Use in Requests for Administrative Review - Fee Petition)

To view the form, go to SSA-795.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203950070
GN 03950.070 - Exhibit - Example of SSA-795, Statement of Claimant or Other Person (For Use in Requests for Administrative Review - Fee Petition) - 03/08/1995
Batch run: 09/05/2019
Rev:03/08/1995