Request to Seek Correction of Information Under Section 515

Important Note:	Do not seek correction of personal information through the procedures described below. To seek correction of information related to individual records, benefits, or earnings, please call us at 1-800-772-1213 or contact us.
	To seek a correction under section 515 of information maintained and disseminated by the Social Security Administration, follow the submittal procedure. The information below will help us to respond to your request.
Publication/ Report Title (Include date and publication number if any):
If found on our website, please indicate web page address (url):
Describe the information that you believe needs correction:
Describe why you believe the information needs correction and the impact of information you believe is in error (Cite relevant documents):
Name:
Organizational Affiliation (if any):
How would you like us to respond to you?	[ Mail ] [ Email ] [ Fax ]
Mailing address:
Email:
Fax:
May we contact you by phone for clarification?	[ Yes ] [ No ]
If yes, enter phone:
	Print this page if you wish a printed copy of your submittal.
	Mail requests may be sent to: Social Security Administration Office of Public Inquiries Section 515 Windsor Park Building Baltimore, MD 21235-6401 Fax requests may be sent to: 410-965-0695


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