PostalForm
Step 1 of 3Social Security Administration · SSA-795 · 06-2022

SSA-795 Customer-Assembly Preparation Kit

This workflow helps you prepare an SSA-795 factual statement requested by Social Security. PostalForm prepares the official form and delivers the unsigned preparation kit only to your verified address. PostalForm does not file, serve, or submit it. Review the statement, hand-sign and date it in ink, complete any witness section required for an X mark, add requested evidence, and return it to the SSA office handling the matter yourself.

Prepare SSA-795 for your own final assembly and submission

PostalForm prepares and prints an unsigned customer-assembly kit and sends it only to your verified address. You perform final assembly and submission.

Preparation and delivery record only — not proof of filing or agency receipt
Current step
Whose record is this?
Are you making this statement about someone else's Social Security record?, Name of the person the Social Security record belongs to, and That person's Social Security number
This step
3 fields · 3 required

PostalForm is not affiliated with Social Security Administration.

Step 1

Whose record is this?

Tell us who the Social Security record belongs to and who is making the statement.

3 required
Are you making this statement about someone else's Social Security record? *

Answer No if this is about your own benefits or claim (most common). Answer Yes if you're providing facts about someone else's claim — for example, your child, spouse, or someone you know.

Enter the name exactly as it appears on the Social Security card or on letters from SSA. If the statement is about your own record, that's you.

SSA uses this to match the statement to the right record.

Need more context?

The form is ready to fill now. If you want supporting instructions, mailing notes, or source links, they are below.

Important details+

Answer the guided questions and PostalForm prepares the official form, leaves signature areas blank, adds a customer instruction cover, and sends the packet only to your verified address. Nothing is filed or submitted for you. Review the statement, hand-sign and date it in ink, complete any witness section required for an X mark, add requested evidence, and return it to the SSA office handling the matter yourself.

What you need+
  • Name and Social Security number of the person the record belongs to
  • What SSA asked you to explain (check the letter or ask the representative)
  • Your statement, in your own words
  • Signature, date, mailing address, and a daytime phone number
  • Hand-sign the printed form after the preparation kit is delivered
  • Supporting documents (optional) (optional) — If SSA asked you to include proof — pay stubs, letters, or receipts — add it to the customer kit before final submission.
Form summary+

This workflow helps you prepare an SSA-795 factual statement requested by Social Security. PostalForm prepares the official form and delivers the unsigned preparation kit only to your verified address. PostalForm does not file, serve, or submit it. Review the statement, hand-sign and date it in ink, complete any witness section required for an X mark, add requested evidence, and return it to the SSA office handling the matter yourself.

How it works+
  1. Answer the guided questions and review the prepared form information.
  2. PostalForm prints the official form with signature areas left blank and sends the customer-assembly kit only to your verified address.
  3. After delivery, follow the cover instructions, hand-sign where required, and add every original, certified record, payment, witness, certification, companion form, or other physical item.
  4. Verify the current deadline and destination, then personally complete final submission through the official channel.
Where it gets mailed+

PostalForm mails the unsigned preparation kit to you. You complete the signatures, physical enclosures, and final submission yourself.

Packet order+
  • Customer assembly instruction cover (remove and keep before final submission)
  • Prepared unsigned form (signature and reserved third-party fields blank)
  • Printed reference attachments
Common mistakes+
  • Arguing or pleading instead of stating facts — SSA wants dates, names, places, and amounts.
  • Leaving out the claimant’s Social Security number, so the statement can’t be matched to the claim.
  • Missing the reply deadline printed on the SSA letter that asked for the statement.
  • Mailing it to SSA headquarters in Baltimore instead of the local office handling the claim.
  • Forgetting the two required witnesses when the statement is signed with an X mark.
FAQs+
What is Form SSA-795 used for?

Social Security uses the SSA-795 whenever it needs a signed statement and no dedicated form exists — for example, explaining work activity, living arrangements, a marriage or separation, how you manage funds, or any fact an SSA representative asked you to put in writing.

Where do I mail Form SSA-795?

To the office handling your claim. Use the return address on the letter SSA sent you, or look up your local office with SSA’s office locator. Don’t send it to SSA headquarters in Baltimore — that address is only for paperwork-burden comments.

What should I write in the statement?

Answer exactly what SSA asked, in the first person, with specific dates, names, places, and dollar amounts. It is signed under penalty of perjury, so only include things you know are true.

Can I submit the SSA-795 online instead of mailing it?

Yes — SSA’s “Upload Documents” tool in a my Social Security account accepts the SSA-795 electronically. Use this preparation kit only when you want to finish and submit a paper form yourself.

Is there a fee or a processing time?

No fee. The statement becomes part of your claim file, and the office that asked for it reviews it as part of that claim — so mail it promptly, especially if your letter lists a deadline.

Sources+
Related+
Last verified+

Last Social Security Administration verification: July 12, 2026