Notice
Below you can find the forms and instructions necessary for this complaint. It is important to read the Information and Instructions below in their entirety before completing the necessary forms. Case number assignments are made by the Clerk of Court.
Forms
Social Security Complaint The Complaint must be accompanied by a Social Security Identification Form (MOED-0067) and a copy of Appeal Council's Letter You will receive the Appeals Council's letter via U.S. Mail at the physical address the Social Security Administration (SSA) has on file. You can also view and download a digital copy of the notice online by logging into your account on the Social Security Administration
Social Security Identification Form (MOED-0067)
Application to Proceed in District Court without Prepaying Fees or Costs
Civil Cover Sheet (See Instructions on page 2. If necessary, Clerk's Office staff may assist you with the completion of this form.)