Date of request: 09 Jan 2004

Social Security Administration
Office of Central Records Operations
Attention: FOIA Workgroup
P.O. Box 17772
300 N. Greene Street
Baltimore, Maryland 21290

Please send me a photocopy of the actual application for a Social Security card (Form SS-5--Social Security Number Record Third Party Request for Photocopy) filed by the person listed below.

I obtained this information from the Social Security Death Master file at RootsWeb.com, Inc. who obtained it from the Social Security Death Master file, originally compiled by the Social Security Administration.

My understanding is that the fee is $27, when the Social Security number is provided or $29 if the Social Security number is unknown or incorrect. Enclosed is a check or money order for $___________, made payable to the Social Security Administration.

Thank you for your assistance.

CLINKSCALES, J C
247-30-8844
Birth: 30 Jul 1917
Death: 23 Aug 1990

Sincerely,

Address:

Daytime Phone Number: