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Salinas California Form 4180: What You Should Know

CMB: Social Security number SLAB: Social Security number, if applicable, and the social security card number  QL-1: Qualified Medicare Beneficiary Number (CMB) and the taxpayer's Social Security card  QI-1: Qualified Medicare Beneficiary Number (SLAB) and the taxpayer's Social Security card  The Form 4180 should be completed for each of your dependents. It is important that you ask for all information in the document in its entirety because the  IRS Form 4180 Responsible Person Interview (2012) You do not have to return a copy of this Form 4180 to the county social services agency you received it from. If you did obtain a copy, you must provide it along  with a copy of your application for SSI and the QI-1. Any county social services agency you have requested  your copy of the Form 4180 should mail all forms to you within 5 business days. The application form cannot be submitted online or by fax.  To file a CMB request online, go to. If you have not applied for SSI, a separate form (form SSA‑1050)  may be necessary to determine your eligibility for SSI. To file a SLAB request online, go to. To file an SLAB application, go to. If you have not applied for SSI, a separate form (form SSA‑1030)  may be necessary to determine your eligibility for SSI. To file a QI-1 application online, go to.

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