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Report a Death of a Social Security Beneficiary

*Indicates mandatory information​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

 

Report a Death of a Social Security Beneficiary

Details of Person Submitting Report

Details of Deceased Beneficiary

Death/Burial Certificate

A copy of the beneficiary’s death/burial certificate must be attached to this report. A death certificate issued by the Parish Priest is also accepted.

Maximum upload size: 5MB
Confirm that the attached certificate is a true copy and other information submitted is correct and true