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Social Security Administration

Fill out Form SSA-89 online

Authorization for the Social Security Administration (SSA) To Release Social Security Number (SSN) Verification

Form SSA-89 is written consent for the Social Security Administration to check whether a person's name, Social Security number and date of birth match its records, and to give the result to the company named on the form. Companies that use SSA's Consent Based SSN Verification (CBSV) service, such as those that provide banking and mortgage services, credit checks or background checks, ask for it. The consent is for one-time use and only for the purpose selected on the form.

Fill out Form SSA-89Blank form from the SSA

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Edition
(05-2025)
Pages
1
Fillable fields
23
Checked against the SSA
November 8, 2026

GuruPDF is not affiliated with the Social Security Administration. This page explains the form in plain words; it is not legal or tax advice. Always check the official instructions before you file.

Who uses Form SSA-89

  • People asked by a bank, lender, employer or other company to let SSA verify their Social Security number
  • Parents or legal guardians signing for a child under 18
  • Legal guardians signing for a legally incompetent adult
  • Companies enrolled in SSA's CBSV service, which must have a signed form before each verification request

Before you start

  • The name, date of birth and Social Security number of the person the number was issued to
  • The Social Security card, if you have it, to help you enter the name and number correctly
  • The reason the company gave for asking, so you can select the matching box
  • The name and address of the company asking for the verification
  • The name and address of the company's agent, if there is one
  • If you sign for a child or a legally incompetent adult, proof of your relationship, such as a birth certificate or court document

How to fill out Form SSA-89

  1. Printed Name, Date of Birth and Social Security Number

    Enter the name, date of birth and Social Security number of the person the number was issued to. SSA checks all three against its records. The date of birth must be filled in.

  2. Reason for authorizing consent

    Select one box: to apply for a mortgage, a loan, a credit card or a job; to open a bank account or a retirement account; to meet a licensing requirement; or Other. If you select Other, enter the reason in the field for it. SSA verifies the number only for the purpose selected.

  3. The Company

    Enter the Company Name and Company Address of the business that asked for your consent and will receive the result.

  4. The Company's Agent (if applicable)

    If the company works through an agent that requests the verification from SSA, enter the Agent's Name and Agent's Address. Leave these lines blank if there is no agent.

  5. How long the consent lasts

    The consent is for one-time use and is valid for 90 days from the date signed. To set a different period, enter the number of days in the space provided and initial it. Leave the space blank to keep 90 days.

  6. Signature, Date Signed and Relationship

    Sign in ink and enter the Date Signed. If you are not the person the number was issued to, enter your relationship to that person on the Relationship line, for example parent or legal guardian.

  7. Notice to Number Holder

    The part below the TEAR OFF line is a notice to the number holder. It says the company and its agent have an agreement with SSA that limits further use and sharing of the verification result, and it gives the web address of SSA's sample agreement.

After you fill it out

Give the signed form to the company that asked for it, or to its agent, in the way the company tells you. You do not send it to Social Security. The company must have the signed form in hand before it asks SSA to verify the number, and it must keep the form for five years. SSA tells the company whether the information matches its records and adds a death indicator if its records show the person has died.

Signing: SSA's CBSV user agreement says the original Form SSA-89 must have a handwritten ("wet") signature and that the company must not accept digital or electronic signatures. Print the form and sign it in ink.

Watch out for

  • The Signature box in this PDF is a text field. Leave it blank, print the form and sign it in ink.
  • A spouse, an attorney, an appointed representative or someone holding a power of attorney cannot sign this form for you. SSA does not recognize a power of attorney for this consent.
  • A match does not confirm identity, citizenship or permission to work. SSA says CBSV verifications do not satisfy the Department of Homeland Security's Form I-9 requirements.
  • You sign under penalty of perjury. The form warns that knowingly giving false information to get information from Social Security records is a misdemeanor that can bring a fine.

Questions about Form SSA-89

Do I send Form SSA-89 to Social Security?

No. You give it to the company named on the form, or its agent. The company keeps the signed form and sends the verification request to SSA through the CBSV service.

What will Social Security tell the company?

SSA answers yes or no to whether the name, Social Security number and date of birth match its records, and returns a death indicator if its records show the person has died. It does not verify identity. The form also authorizes SSA to give the basis for a no-match when the company is a Permitted Entity under section 215 of the Economic Growth, Regulatory Relief, and Consumer Protection Act.

How long is my consent valid?

It is good for one verification, within 90 days from the date you sign, unless you enter a different number of days on the form and initial it. The company cannot reuse it for another request or another purpose.

Can someone else sign for me?

Only a parent or legal guardian of a child under 18, or the legal guardian of a legally incompetent adult. The company must keep proof of the relationship, such as a birth certificate or court document.

What happens if the result is a no-match?

SSA's CBSV guide tells the company to check the details it sent against your form, and then to ask you to confirm them or show your Social Security card. If that does not resolve it, the company may refer you to your local Social Security office. If SSA's records are wrong, only the number holder can ask SSA to correct them.

Official information

Page text last reviewed November 7, 2026.

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