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847. Sample Indictment—False Social Security Number, 42 U.S.C. § 408(a)(7)(B)

On or about the______day of ____ , in the_________District of_______, defendant JOHN DOE, with intent to deceive, falsely did represent that his social security number was __________ on a bankruptcy petition, Case No. __________, then well knowing that social security number _________ had not been assigned to him by the Secretary or other proper authority.

All in violation of 42 U.S.C. § 408(a)(7)(B).

[cited in USAM 9-41.001]

Updated December 18, 2015