Effective Dates: 12/29/2023 - Present Previous | Next

TN 8 (12-23)

SI 00605.040 Completing Part 9 Signatures of the Application for Supplemental Security Income (SSA-8001-BK)

A. Procedure for explaining question 35 penalty of perjury statement

Explain to the claimant the penalty for providing false information before they sign the application.

B. Procedure for completing questions 36 and 37

Follow the procedure below when completing questions 36 through 37 on the SSA-8001-BK.

1. Questions 36 and 37 Signatures

Complete these questions following instructions in SI 00604.111.

2. Question 38 Witnesses

Complete if the claimant signed by marking “X.” For policy and procedures for the use of alternative signatures, see GN 00205.115B.c.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0500605040
SI 00605.040 - Completing Part 9 Signatures of the Application for Supplemental Security Income (SSA-8001-BK) - 12/29/2023
Batch run: 12/29/2023
Rev:12/29/2023