Application for Survivor's Benefits

Application for Survivor's Benefits

OMB: 0960-0062

IC ID: 8991

Information Collection (IC) Details

View Information Collection (IC)

Application for Survivor's Benefits
 
No Modified
 
Voluntary
 
20 CFR 404.611(c) 20 CFR 404.611(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-24 Application for Survivor's Benefits SSA-24 - Revised.pdf Yes No Fillable Printable
Form and Instruction VA Form 21-534 Department of Veterans Affairs: Application for Dependency and Indemnity Compensation, Death Pension and Accured Benefits by a Surving Spouse or Child (Including Death Compensation if Applicable) VA Form 21-534.pdf No   Printable Only
Other-Revised PA Statement Revised PA Statement.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

3,200 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,200 0 0 0 0 3,200
Annual IC Time Burden (Hours) 800 0 0 0 0 800
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-24 - Current SSA-24 - Current.pdf 02/21/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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