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  2. Forms Repository
  3. WKC-6156-E, Social Security Information

Social Security Information

Document Number: WKC-6156-E

Description: This form should be used by insurance companies to request information from the Social Security Administration regarding an injured person.

Comments: This form is an electronic Microsoft Word template that can be filled out on your computer (if you have Microsoft Word). An electronic PDF (WKC-6156-E) is also provided for your convenience.

Content Contact: Lynn Weinberger

Document Attachments:

WKC-6156-E (Electronic Version - Word/50 KB)

WKC-6156-E (Electronic Version - pdf/124 KB)

Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.

Contact Information