The Social Security Administration will allow you to replace a card up to 3 times every year, since this is one of the most common instances.
Please provide the applicant gender.
Please enter the applicant's full last name as you want it to appear on the Social Security card
Please enter the applicant's full middle name how you want it to appear on the Social Security card.
Please enter the applicant's full first name at birth how you want it to appear on the Social Security card
Please enter the applicant's full middle name at birth as you want it to appear on the Social Security card.
Please enter the applicant's full last name at birth as you want it to appear on the Social Security card.
Have you ever gone by any other name or alias?
Please provide the applicant's alias first name.
Please provide the applicant's alias last name.
Does the name on your most recent Social Security Card match your name above?
Please Enter First Name on most recent Social Security Card.
Please Enter Middle Name on most recent Social Security Card
Please, Enter Last Name on most recent Social Security Card.
Enter the applicant's first name, as you want it to appear on the card.
Please select the country where the applicant was born.
Please select the state where the applicant was born.
Please select the city where the applicant was born.
Please select the applicant's date of birth.
Please enter the applicant's mother's first name.
Please enter the applicant's mother's middle name.
Please enter the applicant's mother's last name (her maiden name).
(If Deceased answer No)
This information is required to complete your Social Security Card replacement process.
Please enter the applicant's father's first name.
Please enter the applicant's father's middle name.
Please enter the applicant's father's last name.
Please enter the street address you would like the social security card mailed to.
Please enter the zip code you would like the social security card mailed to.
Please enter the city of the address you would like the social security card mailed to. (Please do not abbreviate).
Please select the state of the address you would like the social security card mailed to.
Please specify your relationship with the person on the social security card.
Please enter the signer's relationship to the applicant
Please provide your daytime phone number.
Please provide your email address.
Please Re-enter your email address.