Representative Services, Inc.

When filing online at SSA.gov having the following information will make completing the application much easier.
• Your date and place of birth and Social Security number
• The name, Social Security number and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death (if appropriate)
• Names and dates of birth of your minor children
• Your bank or other financial institution’s Routing Transit Number and the account number, if you want the benefits electronically deposited
• Name, address and phone number of someone who knows about your medical conditions and your day to day activities
o Names, addresses, phone numbers, for all doctors, hospitals and clinics you have been treated, including approximately the date of your first visit, last visit, and any up coming appointments.
o Medicines you are taking and who prescribed them
o Names and dates of medical tests you have had and the doctor’s name who ordered the test.
• The amount of money earned last year and this year
• The name and address of your employer(s) for this year and last year
• The beginning and ending dates of any active U.S. military service you had before 1968
• A list of the jobs (up to 5) that you had in the last 15 years including the dates you worked at those jobs