TN 14 (11-25)

RM 10213.025 Exhibit of SSA Verification Request for Department of State (DOS) Records (Form SSA-377)

The SSA-377 titled "Verification Request for Department of State (DOS) Records" is used to request the DOS verify U.S. passports, passport cards, Forms FS-240, FS-545 or DS-1350.

For detailed instructions on completing the SSA-377, refer to RM 10213.010.

This form is available for printing on SSA's Intranet site for electronic forms. Click on inForm.

The SSA-377 attached is for reference only and may also be reproduced locally.

DO NOT PRINT IT FROM POMS.

 

Click here to view the SSA-377 form.