Ssn Correction Form
Download a blank fillable Ssn Correction Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Ssn Correction Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1SOCIAL SECURITY NUMBER
CORRECTION FORM
PLEASE FILL IN ALL REQUESTED INFORMATION NEATLY AND COMPLETELY.
Name: ___________________________________________________Student ID: ______________________________
Athens State University protects the social security numbers of all individuals which are in its possession.
INCORRECT SOCIAL SECURITY NUMBER
CORRECT SOCIAL SECURITY NUMBER
___ ___ ___ / ___ ___ / ___ ___ ___ ___
___ ___ ___ / ___ ___ / ___ ___ ___ ___
Contact Information
Street 1
Street 2
Street 3
City
State
Zip Code
(Area Code)
Telephone Number
Email Address
First Date of Enrollment at Athens State University
_______________________________
Last Date of Attendance
_______________________________
Currently Enrolled
____ Yes
____ No
ATTACH A COPY OF YOUR SIGNED UNITED STATES
SOCIAL SECURITY CARD FOR PROCESSING
__________________________ __________________________
Student Signature
Date
OFFICE OF THE REGISTRAR
Athens State University
300 North Beaty Street
Athens, AL 35611
•
•
256- 233-8131 FAX 256- 233-8163
•
•
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal