TN 5 (03-12)
SI 00604.109 Signatures: General
Regulations - 20 CFR 416.315
Two of the alternative signature methods described in GN 00201.015 apply to Supplemental Security Income (SSI) applications, attestation and witnessed signature (EXCEPTION: MSSICS exclusions). When the claimant files an SSA-8000-BK (Application for Supplemental Security Income) with a pen-and-ink signature, follow the procedures below.
B. Discussion of penalty for false information
Discussion – “Penalty For Providing False Information” Statement
Discuss both the penalty for providing false information and the uses of the information the claimant provided before obtaining his or her signature on the application.
Explain to all claimants:
that we have an obligation to ensure that only eligible claimant receive benefits and that payments are in the correct amounts;
the importance of providing correct and complete information; and
that providing false information is a violation of Federal law, which may lead to prosecution by the U.S. Government.
SI 00604.003 Preliminary Discussion Before Completing the SSA-8000-BK
GN 04105.005 Violations of the Social Security Act
GN 04105.010 The Privacy Act
GN 00201.015 Alternative Signature Methods