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Application for Widow's or Widower's Insurance Benefits--MCS/Signature Proxy
Application for Widow's or Widower's Insurance Benefits
SSA-10-BK--MCS Version
Application for Widow's or Widower's Insurance Benefits--MCS/Signature Proxy
OMB: 0960-0004
OMB.report
SSA
OMB 0960-0004
ICR 200805-0960-006
IC 44959
Application for Widow's or Widower's Insurance Benefits--MCS/Signature Proxy
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0004 can be found here:
2022-06-01 - Revision of a currently approved collection
2019-02-26 - Revision of a currently approved collection
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File Modified
2006-09-08
File Created
2006-09-08
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