Social Security Appeals Package

• Package Cover Sheet and Instructions
• Form Complaint for Appeal of a Decision by the Commissioner of Social Security
• Flow Chart Outlining Filing Process
• A Civil Cover Sheet
• An application to proceed without prepayment of fees
• Three (3) Civil Summons
  • Commissioner of Social Security
  • United States Attorney for the Northern District
  • United States Attorney General.
• Three (3) U.S. Marshal Service Forms (USM) and an instruction sheet for completing these forms
• A Social Security Action - Case Assignment Form
• A copy of General Order 18
• A Notice to Consent to the Exercise of Civil Jurisdiction by a Magistrate Judge