Form preview

SSA-711 2022 free printable template

Get Form
Form SSA711 (042022) Discontinue Prior Editions Social Security Administration Page 1 of 3 OMB No. 09600665REQUEST FOR DECEASED INDIVIDUALS SOCIAL SECURITY RECORD *Use This Form If You Need 1. Photocopy
pdfFiller is not affiliated with any government organization

Get, Create, Make and Sign SSA-711

Edit
Edit your SSA-711 form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your SSA-711 form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit SSA-711 online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use our professional PDF editor, follow these steps:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit SSA-711. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
With pdfFiller, it's always easy to work with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

SSA-711 Form Versions

Version
Form Popularity
Fillable & printabley
4.9 Satisfied (56 Votes)
4.8 Satisfied (68 Votes)
4.3 Satisfied (112 Votes)
4.3 Satisfied (51 Votes)
4.0 Satisfied (60 Votes)

How to fill out SSA-711

Illustration

How to fill out SSA-711

01
Obtain the SSA-711 form from the Social Security Administration website or local office.
02
Fill in your personal information at the top, including your full name, Social Security number, and address.
03
Indicate the type of benefits you are requesting on the form.
04
Provide detailed information regarding the circumstances that necessitate the request.
05
If applicable, include information about any dependent beneficiaries.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form as instructed.
08
Submit the form via mail, fax, or in person at your local Social Security office.

Who needs SSA-711?

01
Individuals applying for a waiver of overpayment or seeking assistance with their Social Security benefits.
02
Beneficiaries who believe they have been incorrectly overpaid and wish to dispute the overpayment notice.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.8
Satisfied
68 Votes

People Also Ask about

An SS-5, the application form used to enroll in the U.S. Social Security program, can be a great genealogical resource for learning more about ancestors who died after the year 1936. Before making an application for a copy of your ancestor's records, you should first locate them the Social Security Death Index.
Do we pay death benefits? A one-time lump-sum death payment of $255 can be paid to the surviving spouse if they were living with the deceased. If living apart and they were receiving certain Social Security benefits on the deceased's record, they may be eligible for the lump-sum death payment.
To proceed, make an electronic Request for Deceased Individual's Social Security Record. Or, print and complete Form SSA-711 and send us a check or money order for the appropriate fee, made payable to the Social Security Administration.
The SS-5 applications are provided to U.S. citizens by the Social Security Administration under the Freedom of Information Act. You must provide proof the person is deceased unless that person is 120 years old or older. You can go right to the Social Security Administration's website to order a copy of the application.
You can apply for benefits by calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting your local Social Security office. An appointment is not required, but if you call ahead and schedule one, it may reduce the time you spend waiting to apply.
The Social Security number application cannot be processed because the applicant refuses to come in for an interview, has failed to submit required evidence, or has immigration documents indicating that the current status will expire within 14 days.
Social Security Number Record Request for Extract or Photocopy. Page 1. Form SSA-L996 (10-2021)
If you have questions or need help understanding how to check the status of your Social Security application online, call our toll-free number at 1-800-772-1213 or visit your Social Security office.
The "Social Security Death Index" is a database created from the Social Security Administration's Death Master File. This is an index of deceased individuals whose deaths were reported to the Social Security Administration. It has been kept since 1962, when operations were computerized.
Documents you may need to provide Proof of the worker's death; Birth certificate or other proof of birth; Proof of U.S. citizenship or lawful alien status if you were not born in the United States [More Info]; U.S. military discharge paper(s) if you had military service before 1968;
You can apply for benefits by calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting your local Social Security office. An appointment is not required, but if you call ahead and schedule one, it may reduce the time you spend waiting to apply.
0:30 1:54 How to Fill Out a Social Security SS-5 Form - YouTube YouTube Start of suggested clip End of suggested clip If you are applying on behalf of a dependent. Child fill out the parental. Information such as theMoreIf you are applying on behalf of a dependent. Child fill out the parental. Information such as the full names and social security. Numbers if you are applying for a replacement.
Who receives benefits? Surviving spouse age 60 or older (age 50 or older if they have a disability). Surviving divorced spouse, under certain circumstances. Surviving spouse at any age who is caring for the deceased's child who is under age 16 or has a disability and receiving child's benefits.
Apply for Survivors Benefits In most cases, the funeral home will report the person's death to us. You should give the funeral home the deceased person's Social Security number if you want them to make the report. If you need to report a death or apply for benefits, call 1-800-772-1213 (TTY 1-800-325-0778).

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Once you are ready to share your SSA-711, you can easily send it to others and get the eSigned document back just as quickly. Share your PDF by email, fax, text message, or USPS mail, or notarize it online. You can do all of this without ever leaving your account.
Yes. By adding the solution to your Chrome browser, you can use pdfFiller to eSign documents and enjoy all of the features of the PDF editor in one place. Use the extension to create a legally-binding eSignature by drawing it, typing it, or uploading a picture of your handwritten signature. Whatever you choose, you will be able to eSign your SSA-711 in seconds.
You can. With the pdfFiller Android app, you can edit, sign, and distribute SSA-711 from anywhere with an internet connection. Take use of the app's mobile capabilities.
The SSA-711 is a form used by the Social Security Administration to report events that may affect an individual's eligibility for benefits.
Individuals who receive Social Security benefits and experience a change in circumstances that could affect their eligibility are required to file SSA-711.
To fill out SSA-711, you need to provide personal information, details about your current benefits, and any changes in your circumstances that may affect your eligibility. It's important to follow the instructions provided with the form.
The purpose of SSA-711 is to notify the Social Security Administration about changes that could impact a beneficiary's eligibility, ensuring that individuals receive the correct benefits.
Information that must be reported on SSA-711 includes changes in income, living arrangements, marital status, or any events that could impact benefit eligibility.
Fill out your SSA-711 online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.