Form SS-5 at a glance
| Official title | Application for a Social Security Card |
| Issued by | Social Security Administration (SSA) |
| Edition | 12-2024 |
| Pages | 5 |
| Fillable fields | 70: 46 text fields, 24 checkboxes |
| OMB number | 0960-0066 |
| Official PDF | ss-5.pdf on ssa.gov |
| Form page | ssa.gov/number-card |
| Cost with FillWise | 1 fill |
Counted on Oct 6, 2026 from the official PDF, with the same engine FillWise fills it with.
What Form SS-5 asks for
- Page 5: First, Full Middle Name, Last, Social Security number previously assigned to the person, PLACE OF, DATE, U.S. Citizen, Allowed To, Work(See Instructions On, Instructions On and more.
The captions printed next to the first fields of each page, as the PDF gives them.
Fields to watch on Form SS-5
- 1 question answered with a Yes box. FillWise ticks one only when your notes answer it; the rest stay empty for you.
- 9 boxes with a fixed number of characters, such as Social Security number previously assigned to the person (3), Last (4), B. PARENT/ MOTHER'S SOCIAL SECURITY (3), Full Middle Name (2). Long numbers are split across them, so check the digits.
How to fill Form SS-5 with FillWise
- Open the official PDF from ssa.gov in Chrome.
- In the FillWise side panel, paste your notes or attach a photo of a document, and press Fill form.
- Check all 5 pages of the downloaded PDF before anyone signs.
Without the extension: Fill a PDF in your account.
How FillWise handles Form SS-5
FillWise fills this form the regular way: the AI reads each field's printed caption, its tooltip and its options, and answers from your notes.
The PDF is encrypted with an empty password; FillWise opens it like any other.
It also carries Adobe XFA data; FillWise fills the regular fields and drops the XFA part, so the result opens in any reader.
What to check before you file
- The edition. Agencies replace their forms with new editions. This page describes the 12-2024 edition; check that your copy is still the current one on ssa.gov/number-card.
- Names and numbers character by character; signatures, fees and supporting documents stay with you.
Filling Form SS-5 for many people
Bulk fill in your FillWise account takes Form SS-5 and a CSV or Excel sheet with one person per row. It fills the first one and stops so you can check the result, then fills the rest and hands back one zip. Each copy costs 1 fill, the same as filling it on its own. How it works step by step: bulk PDF form filling guide.
Cost
Form SS-5 has 5 pages, so filling it costs 1 fill: FillWise charges a PDF fill by the pages it fills, one fill per started 5 pages. The free plan starts with 20 fills and then tops back up to 5 fills a week, no card required. Paid plans are on the pricing page.
Privacy
The PDF is filled in your browser; only its field list and your data go to our server for the AI, and nothing is stored. Details: privacy and security.