Updated October 19, 2026. Quick answer: Form SSA-89 is the Authorization for the Social Security Administration to Release Social Security Number Verification. You sign it so a named company, such as a mortgage lender or employer, can ask SSA to match your name, SSN and date of birth. It is valid for one use and, unless you say otherwise, for 90 days from the date signed. It confirms a match; it does not release your earnings record or benefits.
Quick reference
| Item | As printed on the form |
|---|---|
| What the form is | One-time consent for SSA to verify your SSN to a named company |
| What SSA checks | Name, SSN and date of birth against SSA records |
| Valid for | One use; 90 days from the date signed |
| Change the period | Write your own number of days; 90 days applies if you do not |
| Who signs | The person the SSN was issued to, or a parent or legal guardian |
| Reasons listed | Mortgage, bank account, credit card, loan, retirement account, job, licensing requirement, other |
| False statement penalty | Misdemeanor and a fine up to $5,000 |
| Time to complete | About 20 minutes, per the form |
What you are authorizing
The core sentence is: “I authorize the Social Security Administration to verify my SSN (to match my name, SSN, and date of birth with information in SSA records and provide the results of the match) to the Company or Company’s Agent, if applicable, for the purpose I identified.” The form also lets SSA disclose the basis for a no-match when the company is a permitted entity under section 215 of the Economic Growth, Regulatory Relief, and Consumer Protection Act.
That is a narrow release: a match of three data points for one named company. The form authorizes nothing else, and your earnings history is a separate record, covered on our page on your earnings record.
What you fill in
You print your name, date of birth and SSN, then choose one reason for the consent: to apply for a mortgage, open a bank account, apply for a credit card, apply for a loan, open a retirement account, apply for a job, meet a licensing requirement, or other. You then name the company, its address and, if applicable, its agent and the agent’s address.
The signer is described as “the individual to whom the SSN was issued or the parent or legal guardian of a minor or legally incompetent adult.” If someone else signs, the form has a line for the relationship.
How long the consent lasts
Two limits are printed together: “This consent is valid only for one-time use.” and “This consent is valid only for 90 days from the date signed, unless indicated otherwise by the individual named above.” To change the period you fill in a number of days and initial it. A shorter period is the safer choice when the company only needs one answer.
Before you sign, read the tear-off notice. It says the company and its agent “have entered into an agreement with SSA that, among other things, includes restrictions on the further use and disclosure of SSA’s verification of your SSN.”
Warnings, and when to be careful
The signer declares the information true under penalty of perjury, and the form states “I acknowledge that if I make any representation that I know is false to obtain information from Social Security records, I could be found guilty of a misdemeanor and fined up to $5,000.”
A no-match is often a name problem. The card booklet says “If you legally change your name because of marriage, divorce, court order, or any other reason, you need to tell us so we can issue an updated card.” It also stresses “It is critical that your name and SSN on your Social Security card match your employer’s payroll records and Form W-2.”
Be sure the company named is the one you are dealing with. Spend a minute on the company name and address fields, because they decide who receives the answer, and do not sign one for an organization you have not chosen to deal with.
The edition read for this page is Form SSA-89 (05-2025) as the agency served it on 2026-10-19. Check the edition printed on the copy you use, because a later edition can change the questions, the mailing instructions and the evidence asked for.
Common mistakes
- Treating the form as a release of your earnings record or benefit amount. It verifies a name, SSN and date of birth match.
- Leaving the company fields blank or vague. The consent is for the named company or its agent only.
- Assuming it can be reused. The form says it is valid only for one-time use.
- Signing for a request you did not start. Only complete it for a lender, bank or employer you approached.
Related: your earnings record, and Social Security and Medicare forms.
Sources
- Form SSA-89 (05-2025), Authorization for the Social Security Administration to Release Social Security Number Verification: https://www.ssa.gov/forms/ssa-89.pdf
- SSA Publication 05-10002, Your Social Security Number and Card: https://www.ssa.gov/pubs/EN-05-10002.pdf
Read from the Social Security Administration and Centers for Medicare and Medicaid Services documents linked above on October 19, 2026. General information, not legal or benefits advice. Your own facts decide the outcome, and Social Security at 1-800-772-1213 is the right place to confirm anything consequential.