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Form SSA-4111 Certificate of Election for Reduced Widow(er)�s Benefits
Certificate of Election for Reduced Widow(er)s Benefits
ssa4111
Certificate of Election for Reduced Widow(er)s Benefits (SSA-4111)
OMB: 0960-0759
OMB.report
SSA
OMB 0960-0759
ICR 200705-0960-007
IC 180150
Form SSA-4111 Certificate of Election for Reduced Widow(er)�s Benefits
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0759 can be found here:
2022-09-02 - Revision of a currently approved collection
2019-05-24 - Revision of a currently approved collection
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application/pdf
Subject
ssa4111
Author
[email protected]
File Modified
0000-00-00
File Created
2007-04-02
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