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Work Activity Report - Form SSA-821-BK |
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How to Obtain the Form |
Below you will find Form in Portable Document Format (PDF). To print the PDF version, you will need the Adobe Acrobat reader software. If you do not already have this special software, see our page on downloading and printing PDF documents. After you download the Adobe Acrobat Reader, come back to this page and download the PDF version of the SSA-821-BK: SSA-821 in
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How to Complete the Form |
The claimant, beneficiary, or his or her representative completes items 1 through 10 in Part II. We consider the SSA-821-BK to be a self-help form. |
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Where To Send The Form |
Print the PDF SSA-821-BK on 8 ½ x 11 inch paper, complete and sign the form, and mail it to your local Social Security office. If you are not sure where your local office is located, try our Social Security Office Locator service or call 1-800-772-1213. |
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Last reviewed or modified Wednesday Feb 09, 2011 |