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Templates
Government forms
Work History Report (Form SSA-3369-BK) - Dec 2014

Government forms

Work History Report (Form SSA-3369-BK) - Dec 2014

This form is used to request vocational information in order to evaluate an individual's disability claim.

Originally published by: ssa.gov

Used 234 times

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Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

Large thumbnail of Work History Report (Form SSA-3369-BK) - Dec 2014

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Frequently asked questions

The SSA 3369 form is used to gather vocational information for the evaluation of a disability claim. The form should be completed by individuals who are filing a disability claim with the Social Security Administration. Once completed, the form should be submitted directly to the Social Security Administration.
Individuals who are filing a disability claim with the Social Security Administration.
The completed form should be submitted to the Social Security Administration.

Used 234 times