SSA-521 - Request for Withdrawal of Application


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Get your SSA-521 - Request for Withdrawal of Application in 3 easy steps

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What is SSA 521?

SSA 521 Request for Withdrawal of Application is a two-page document you can use to cancel your application for any benefits from social services within one year. Although it is a fairly simple blank that does not require any additional paperwork, be aware that if your Form SSA-521 PDF is approved, you must return any payouts already received into your account.

SSA-521 on PDFLiner

What do I need the SSA Form 521 for?

  • The SSA 521 printable form can be used if the payout and the conditions you need to meet to receive it would potentially harm you more.
  • The most common use case for a Social Security Request for Withdrawal of Application is to withdraw an application from someone who has reached retirement age but decided to continue working. In this case, your salary might be higher than SSA payments.
  • Don’t rush to use SSA-521 PDF unless you are sure. We recommend consulting with a specialist from the Social Security office in your area.

How to Fill Out Form SSA-521?

  1. First, the applicant must enter their name and SSN. Then, you need to specify which benefit you would like to refuse using SSA-521 fillable blank.
  2. Also, enter the date you submitted your first application. If you wish, you can remain eligible for Medicare benefits.
  3. Specify the reason for completing Form SSA-521 Request for Withdrawal of Application. It can be our example from the previous block or any other option. If you need more space to describe your situation, use the blank lines on the second sheet.
  4. Date the printable SSA 521 and put your signature, address, and contact details.
  5. If the placeholder is unable to properly sign (uses “x” instead) the file, then the SSA 521 PDF must also be signed by two witnesses attesting to the beneficiary’s voluntary actions.
  6. After completing the SSA Form 521 download it to your device, email it to the administration, or print it out.

SSA-521 on PDFLiner

Organizations that work with Form SSA 521

  • SSA

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(5 / 5) 69 votes
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