Social Security Affidavit Form

June 1, 2011

A social security affidavit form is a legal document that clearly states the legalities in regards to the provision of social security to a person by the concerned administration. The details of the person – his/her name, address, contact details plus the nature of security and other regulatory information are filed in the affidavit form.
Sample social security affidavit form:

Date of filling the form: ____________


Nature/type of the social security: _________________

Main features of the social security:


Tenure of the social security:


Name of the person to whom the social security will be provided:


Signature of the person:  ___________________

Date of Birth: _________________

Identification proof: ________________

Full contact address: ________________

Contact phone number: _________________

The authority providing the social security: _____________________

Legality details of the provision for the social security:


The official statement of declaration of social security affidavit:

Signature of the administrative authority:



Download Social Security Affidavit Form In Word Format

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