Information Collection

Claim for Amounts Due in the Case of a Deceased Beneficiary

IC 43696 under ICR 200902-0960-020 · OMB 0960-0101.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0101 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-1724 Claim for Amounts Due in the Case of a Deceased Beneficiary Form and Instruction
SSA-1724 Claim for Amounts Due in the Case of a Deceased Benefici S1724-09 Mock up.pdf Form and Instruction
ssa-1724.pdf SSA-1724 Current Version IC Document
SORN 60-0090.pdf SORN IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claim for Amounts Due in the Case of a Deceased Beneficiary	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.503 (b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-1724	Claim for Amounts Due in the Case of a Deceased Beneficiary	S1724-09 Mock up.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	250,000	-250,000	500,000
Annual IC Time Burden (Hours)	41,667	-41,666	83,333
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-1724 Current Version	ssa-1724.pdf	04/23/2009
SORN	SORN 60-0090.pdf	04/23/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.