Simply click on the form you wish to download:
| 30K Bytes | |
| 476K Bytes | |
| Physician's/Medical Officer's Statement of Patient's Capability to Manage Benefits - Page 2 | 232K Bytes |
| Advanced Notification Form | 227K Bytes |
| Bank of America Debit Card Application - Page 1 | 944K Bytes |
| Bank of America Debit Card Application - Page 2 | 1.14M Bytes |
For individuals that currently HAVE a payee, the following forms need to be completed:
- Advanced Notification Form (requires client signature)
- Client Information Sheet
For individuals that DO NOT HAVE a payee, the following forms need to be completed:
- Physician Statement (to be completed by attending physican)
- Advanced Notification Form (requires client signature)
- Client Information Sheet
Please Note: If an individual does not want a payee and will not sign the Advanced Notification, a payee will be assigned by the Social Security Administration if the Physician Statement is completed. Once SBS, Inc. submits the Physician Statement to the Social Security Administration, a letter will be sent to the individual explaining that a payee has been assigned to them and they have 15 days to show medical evidence that thay can act as their own payee. The Social Security Administration does not recognize power of attorneys.
These forms files are available here in Adobe Reader format (PDF). If you don't have the Adobe Reader application installed, simply click on the Adobe link below to download and install the latest version of the FREE Adobe Reader.
