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Form #645Marriage Certification
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SOCIAL SECURITY ADMINISTRATION MARRIAGE CERTIFICATION TOE 120/420 Form Approved OMB No. 0960-0009 SEE PAPERWORK/PRIVACY ACT NOTICE ON REVERSE. PRINT NAME OF WAGE EARNER OR SELF-EMPLOYED PERSON SOCIAL SECURITY NUMBER / / I am the spouse of the person named below, who has applied for insurance benefits under the Title II of the Social Security Act, as presently amended. NAME OF SPOUSE (First Name) (Maiden Name, if applicable) (Last Name) 1. Indicate whether your present marriage was p
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to hold this site, its officers, employees and any contributors to this site harmless
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