TN 3 (09-09)

A. Applicant completes application for an SSN card in the FO

When an applicant applies for an SSN card in the FO:

1. Read the following script to inform the applicant that we do not require a pen-and-ink signature:

   “During this interview, we will ask you questions that will be used to process (your/ name of number holder) application. At the end of the interview, we will ask you to confirm the truthfulness of your answers under penalty of perjury and we will record your response. You should be aware that you can be held legally responsible for giving us false information.”

   Spanish

   Durante esta entrevista, le haremos preguntas que se usarán para procesar la solicitud (suya/de name of number holder). Al final de la entrevista, le pediremos que confirme la veracidad de sus respuestas bajo pena de perjurio y documentaremos su respuesta. Debe estar conciente que de acuerdo con la ley podría ser legalmente responsable por darnos información falsa.

2. Complete the appropriate SSNAP screens.

3. Print the SSNAP printout and give to the applicant to review. Read the following script:

   “Here is a printed copy of the information that will be used to process (your or name of number holder) application. Please review all the information carefully and tell us if anything needs to be corrected.”

   Spanish

   Aquí está una copia impresa de la información que se usará para procesar la solicitud (suya/de name of number holder). Favor de revisar toda la información cuidadosamente y díganos si hay algo que tengamos que corregir.

4. Make corrections, if necessary, and reprint the SSNAP printout for the applicant’s approval.

5. When the applicant agrees with the information on the application, read the following script from the SSNAP Verify and Sign screen:

   “Do you understand that the information you gave us and examined will be used to process (your/name of number holder) application? Do you declare under penalty of perjury that this information is true and correct to the best of your knowledge?”

   Spanish

   Entiende que la información que nos dio y revisó se usará para procesar la solicitud (suya/de name of number holder)? Declara usted bajo pena de perjurio que esta información es cierta y verdadera según su mejor entender?

6. Annotate one of the following on the SSNAP Verify and Sign screen based on the applicant’s response to the above question.

   If the applicant…	Choose…
   Responds “Yes”	Attestation
   Does not agree to the statement	Refusal. When refusal is chosen, explain to the applicant that the application cannot be processed. SSNAP gives you the option to print an SSA-L676 refusal letter.

   NOTE: If the applicant insists on signing the SSNAP printout, they may do so. However, the SSNAP printout is not an application and he or she must also respond to the attestation statement.

7. Shred the SSNAP printout when the application is successfully processed, unless the applicant asks to keep it.

B. SS-5 mailed to FO

Record the applicant’s signature for a properly completed and signed Form SS-5 received in the mail with all required documentation as follows:

1. Enter data from Form SS-5 into SSNAP.

2. Carefully review the SSNAP printout to ensure that all fields on the paper application are keyed correctly.

3. Choose “Signature on application” in the “Type of Signature” field on the Verify and Sign screen in SSNAP.

4. Shred the SS-5 when the application is successfully processed in SSNAP.

5. Return the documents submitted with the application (see Returning Documents Submitted for an SSN Card, RM 10205.092).

REFERENCE

RM 10205.180, Applicant’s Signature on a Form SS-5 Received in the Mail