Social Security Card Application

CLOSE‐HIPP BUILDING SUITE 650  COLUMBIA, SC 29208 PHONE: 803‐777‐7461  FAX: 803‐777‐0462  E‐MAIL: [email protected]  S C . E D U / I N T E R N A T I O N A L S E R V I C E S How to Apply For a Social Security Card
Please Note: You should wait at least 2 weeks after you enter the United States to apply for a
Social Security Card. The Social Security office must receive verification of your legal entry
into the USA before you can apply for a card.
1. AN EMPLOYMENT VERIFICATION LETTER IS REQUIRED BEFORE YOU MAY
APPLY FOR A SOCIAL SECURITY NUMBER. See the section below about this
letter.
2. Once the Employment Verification Letter is completed, it must be approved and stamped by
International Student Services.
3. Complete the attached application for a Social Security Card.
4. Bring all of these items to the Social Security Office to apply for your card:
 Social Security Application
 For F-1 Visa Holders: Employment Verification letter
 For J-1 Visa Holders: Letter from Sponsor and
International Student Services
 Passport
 Visa
 I-20 or DS-2019
 I-94 Card or Copy of Electronic I-94 from
www.cbp.gov
Sample Employment Verification Letter:
In order to obtain a Social Security number, F-1 students must provide proof of on-campus employment. Along
with the completed application, students must provide the Social Security office with an Employment
Verification Letter:
 The Employment Verification Letter must be completed by the department hiring the student, and it
must be typed and printed on USC letterhead.
 Before going to the Social Security Office, students must have the Employment
Verification Letter approved and stamped by International Student Services.
 The job description is a one sentence description of the daily duties of the job.
 The letter must include the signature of the department contact and include all fields below:
PLEASE SEE THE NEXT PAGE FOR A SAMPLE EMPLOYMENT VERIFICATION
LETTER.
Sample Employment Verification Letter
The letter will be written by your academic department and must contain all the information
included in the sample below and be stamped by the International Student Services office.
57-600-1153
The letter must be
stamped by the
International Student
Services office before
you go to the Social
Security office.
Map to the Social Security Administration Office
Social Security Administration
Strom Thurmond Federal
Building
1835 Assembly Street, 11th Floor
Columbia, SC 29201
Office Hours
Monday: 9:00am - 4:00pm
Tuesday: 9:00am - 4:00pm
Wednesday: 9:00am - 12:00pm
Thursday: 9:00am - 4:00pm
Friday: 9:00am - 4:00pm
Saturday: Closed
Sunday: Closed
For more information:
www.ssa.gov
International Student Services
Close-Hipp Building
1705 College Street, Suite 650
Columbia, SC 29208
SOCIAL SECURITY ADMINISTRATION
Application for a Social Security Card
NAME
Form Approved
OMB No. 0960-0066
First
Full Middle Name
Last
First
Full Middle Name
Last
TO BE SHOWN ON CARD
1
FULL NAME AT BIRTH
IF OTHER THAN ABOVE
OTHER NAMES USED ON YOUR
SOCIAL SECURITY CARD
2
Social Security number previously assigned to the person
listed in item 1
3
PLACE
OF BIRTH
Office
Use
Only
(Do Not Abbreviate)
5
City
State or Foreign Country
CITIZENSHIP
(Check One)
RACE
Are You Hispanic or Latino?
(Your Response is Voluntary)
Yes
8
9
Select One or More
(Your Response is Voluntary)
7
-
4
FCI
Legal Alien
Allowed To
Work
U.S. Citizen
ETHNICITY
6
-
DATE
OF
BIRTH
MM/DD/YYYY
Legal Alien Not
Allowed To Work (See
Instructions On Page 3)
Other
(See Instructions
On Page 3)
Native Hawaiian
American Indian
Other Pacific Islander
Alaska Native
Black/African American
White
Asian
No
SEX
Male
A. MOTHER'S NAME AT
HER BIRTH
Female
First
Full Middle Name
B. MOTHER'S SOCIAL SECURITY
NUMBER (See instructions for 9 B on Page 3)
Last Name At Her Birth
-
First
-
Full Middle Name
Unknown
Last
A. FATHER'S NAME
10 B. FATHER'S SOCIAL SECURITY
-
NUMBER (See instructions for 10B on Page 3)
11
12
-
Unknown
Has the person listed in item 1 or anyone acting on his/her behalf ever filed for or received a Social Security number
card before?
Yes (If "yes" answer questions 12-13)
Don't Know (If "don't know,"
skip to question 14.)
No
Name shown on the most recent Social
Security card issued for the person
listed in item 1
First
Full Middle Name
any different date of birth if used on an
13 Enter
earlier application for a card
TODAY'S
14 DATE
MM/DD/YYYY
(
15 DAYTIME
PHONE NUMBER
MM/DD/YYYY
Last Name
)
-
Area Code
Number
Street Address, Apt. No., PO Box, Rural Route No.
16 MAILING ADDRESS
State/Foreign Country
City
(Do Not Abbreviate)
ZIP Code
-
I declare under penalty of perjury that I have examined all the information on this form, and on any accompanying statements or forms,
and it is true and correct to the best of my knowledge.
17 YOUR SIGNATURE
18
YOUR RELATIONSHIP TO THE PERSON IN ITEM 1 IS:
Self
Natural Or
Adoptive Parent
Legal
Guardian
Other (Specify)
DO NOT WRITE BELOW THIS LINE (FOR SSA USE ONLY)
NPN
PBC
DOC
EVI
EVA
EVC
NTI
CAN
PRA
NWR
ITV
DNR
UNIT
SIGNATURE AND TITLE OF EMPLOYEE(S) REVIEWING
EVIDENCE AND/OR CONDUCTING INTERVIEW
EVIDENCE SUBMITTED
DATE
DCL
Form SS-5 (08-2009)
ef (08-2009)
Destroy Prior Editions
Page 5
DATE