NAME OF CHILD ADDRESS OF CHILD Include house number street apt. number P. O. Box rural route city state and ZIP code Form SSA-1724-F4 01-2010 EF 10-2012 Use Prior Editions Page 1 If any child listed in item 2 has a different name from that given at birth attach a separate sheet with the following information Child s Present Name Name Given At Birth and a brief explanation for the difference e.g. Marriage or Court Order. Form Approved OMB No* 0960-0101 Social Security Administration CLAIM FOR AMOUNTS DUE IN THE CASE OF A DECEASED SOCIAL SECURITY RECIPIENT PRINT NAME OF DECEASED SOCIAL SECURITY NUMBER OF DECEASED NAME OF THE WORKER If the deceased received benefits on another person s record print name of that worker The deceased may have been due a Social Security payment at the time of death. The Social Security Act provides that amounts due a deceased may be paid to the next of kin or the legal representative of the estate under priorities established in the law. To help us decide who....
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How to fill out the SSA-1724-F4 online
The SSA-1724-F4 form is essential for claiming amounts due in the case of a deceased beneficiary. This guide will provide you with clear, step-by-step instructions to help you successfully complete the form online and ensure that you receive the benefits owed to you or the estate of the deceased.
Follow the steps to fill out the SSA-1724-F4 correctly.
- Press the ‘Get Form’ button to retrieve the SSA-1724-F4 form and open it in your online editor.
- Provide the name of the deceased individual at the top of the form, ensuring to include any other names they may have used for Social Security purposes if applicable.
- Enter the Social Security number of the deceased. This is crucial for identifying the correct beneficiary record.
- Complete the field for the name of the worker if the deceased received benefits on another person's record.
- Fill in the date and state of death in the provided sections to establish legal beneficiary claims.
- Print your name and indicate your relationship to the deceased in the specified areas, using neutral language.
- Detail the next of kin or legal representative of the deceased by filling out each section as applicable, including names and addresses.
- If there is a surviving widow or widower, complete the necessary questions regarding residency and entitlement.
- List the number of living children of the deceased, and provide detailed information for each child, including their address and Social Security number.
- If any child has a different name from their birth name, attach a separate sheet with the required details.
- Include details about the living parents of the deceased, if applicable, or move on to the legal representative section if there are no living parents.
- If there is a legal representative, fill in their name and address. Attach any required documentation, such as letters of appointment.
- Declare the accuracy of the information provided by signing the form, including your name, date, and contact information.
- If applicable, include witness signatures and addresses if the signature was marked instead of signed.
- Conclude by saving any changes, and choose to download or print the completed form for submission.
Submit your SSA-1724-F4 form online to ensure a timely processing of your claim.
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