Social Security Administration

SSA-795 Statement of Claimant or Other Person

Prepare a clear statement for Social Security, with the right person and signer details.

Answer a short set of plain-English questions, review the statement, then print and sign the official SSA-795.

Average time

About 15 minutes

Difficulty

simple

Best for

Giving SSA a signed statement about yourself or someone else

What this form stands for

Prepare a clear statement about the right person, then have the person speaking for the facts sign it in ink.

The signer declares the information true and correct under penalty of perjury, and signing by mark requires two witnesses.

The full name and Social Security number of the person this form is about
The facts the person giving them needs to tell SSA
The phone number and mailing address of the person who will sign
Two witnesses who know the signer only if the person will sign by mark; their signatures and addresses stay on the official form

Identify who this form is about and who is giving the facts.

Write the facts the signer will certify as true.

Add the signer's contact details and learn any manual witness requirement.

Check the completed form, print it, and collect the required ink signatures.

Docgle asks calm, plain-English questions and keeps the official source attached for review.