How to complete an SSA 1372 (Step by Step)
To complete a SSA-1372-BK, you will need to provide the following information:
- Name and address
- Social security claim number
- Name of child beneficiary to whom this statement applies
- Date child attains age 18
- Current school attendance
- Whether you are in school full-time
- School’s name and address
- School year beginning and end date
- Type of school program
- Hours per week you are scheduled to attend
- Expected graduation date from secondary school
- Last school year
- School’s name and address
- Past dates of attendance
- Type of school program
- Hours per week you were scheduled to attend
- Whether you are disabled
- Whether you are married
- Whether you expect to earn more than a certain amount in a certain year
- What you expect your total earnings to be in a certain year
- The first month you expect to earn over a certain amount in a certain year
- Whether you are being paid by your employer to attend school
- Whether you have a bank account
- Whether you have an unsatisfied warrant for your arrest for a crime or attempted crime of flight to avoid prosecution or confinement or escape from custody
- Signature of student
- Name
- Mailing address
- Student’s social security number
- Telephone number
- Date
- Certification by School Official
- Name of student
- Social security claim number
- Certification all information on page two lines 1 and t2 is correct according school records
- Whether school’s course of study is at least 13 weeks in duration
- School’s operating basis
- Whether you received pages 4 and 5 of this form for reporting changes in the student’s attendance
- Whether you annotated page 4 of the form with the student’s expected graduation date
- School official signature
- Title
- Printed name
- Date
- Phone number
- Notice of Cessation of Full-time School Attendance
- Name of social security beneficiary
- Date of birth
- Social security claim number
- Student’s social security number
- Student’s expected graduation date
- Date student ceased to be a full-time student
- Reason for withdrawal
- Name and address of school
- Signature
- Printed name
- Title
- Date