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Social Security Application

Find below the forms that together comprise the Social Security Disability Application!  All portions should be filled out. 

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SSA-16
SSA-3368-BK
SSA 827 - Release of Information


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​Frequently Requested Forms

Social Security requests standard forms be completed during the Disability process.  We encourage clients to get a jump-start on these in order to help save precious time during this long process. 
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Adult Function Report
Work History Report
Request for Waiver of Overpayment



​​Representation Forms

Sign the following forms to allow Mundy & Burch to serve you in your Disability case!
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SSA 827 - Release of Information
SSA 1696 - Appointment of Representation
Fee Agreement
Medical Release Form


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We include this for your convenience.  However, by simply filling this out you are neither applying for disability nor hiring us as your legal counsel. Please reach out to our office after filling this out to setup a formal consultation to initiate a legal bond as attorney and client. 
The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.
  • Home
  • Our Attorneys
  • Practice Areas
  • Contact Us
  • MEET OUR TEAM
  • Disability Application & Forms
  • Video Vault