Get Ssa 4169

Filling out the Ssa 4169 form is essential for reporting designated burial funds to the Social Security Administration. This guide provides step-by-step instructions to ensure you complete the form accurately and effectively.

Follow the steps to successfully complete the Ssa 4169 form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the first section, enter the name of the individual or parent and their social security number. Make sure to double-check these details for accuracy.
3. Next, provide the name of the spouse or parent’s spouse, along with their respective social security number.
4. Fill in the section designated as ‘Re’ with a description of the resource(s) that are set aside as funds for burial purposes. Be as specific as possible.
5. Review the understanding statement regarding the segregation of burial funds from non-burial resources. It is important to acknowledge this requirement to comply with SSI regulations.
6. Sign and date the form in the designated areas for both the individual (or parent) and the spouse (or parent’s spouse). Include the current date formatted as Month, Day, Year.
7. Once all sections are completed, you can save changes, download, or print the form for your records. Ensure that you share it as necessary with the relevant authorities.

Complete your Ssa 4169 form online today to ensure compliance with SSI requirements.