Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the first section, input the name and Social Security number of the Worker (the individual on whose earnings record you are filing). Make sure to print the information clearly.
3. Provide your own name and Social Security number if you are not the Worker. If you are the Worker, skip this step.
4. In Part 1, list all of the Worker’s children and dependent grandchildren who may be eligible for benefits. For each child, indicate their relationship to the Worker, date of birth, and Social Security number.
5. If any children listed are stepchildren, provide the date the Worker married their natural parent. If there is a legal representative for any of the children, fill out the required information regarding them.
6. Answer questions regarding the adoption status of the children, their living arrangements, and if any previous application has been filed for their benefits.
7. Continue with the earnings information for the past year, current year, and expected earnings for next year, including whether any child earned over the exempt amount.
8. Complete any necessary information regarding the deceased if applicable. This includes the Worker’s details like date of birth and place of death.
9. Sign and date the form at the bottom. Include your daytime contact number and mailing address to ensure the Social Security Administration can reach you for any follow-up.
10. Once completed, you can save your changes, download, print, or share the form as needed to finalize your submission.

Start completing your Form SSA -4- BK online today to ensure you apply for the benefits your child may be eligible for.