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From: Glenda Middleton Calfee< >
Subject: Re: social security card application
Date: Wed, 8 Nov 2000 09:52:12 -0800 (PST)


Here is another variation of SS-5 application

No. 1 Employee`s name
No. 2 Street and Number
No. 3 Post office
No. 4 Business Name of Present Employer
No. 5 Business Address of Present Employer
No. 6 Age at Last Birthday
No. 7 Date of Birth (Month) (Day) (Year) (Subject to Later Verification)
No. 8 Place of Birth
No. 9 Father`s Full Name Regardless of Whether Living or Dead
No. 10 Mother`s Full Maiden Name, Regardless of Living or Dead
No. 11 Sex- Male___ Female___ (Check Which)
No. 12 Color White___Negro___Other (Check Which)
No.13 Give Date You Became an Employee (If You Began Employment After
Nov. 14, 19??)
No. 14 Have you Filled Out a Card Like This Before?
No. 15 Date Signed
No. 16 Employee`s Signature As Usually Written---DO NOT PRINT

-----Glenda------


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