Deceased Individual's Social Security Records, SSA-711 (Paper Form)

Report of Deceased Individual's Social Security Record

OMB: 0960-0665

IC ID: 43711

Information Collection (IC) Details

View Information Collection (IC)

Deceased Individual's Social Security Records, SSA-711 (Paper Form)
 
No Unchanged
 
Voluntary
 
20 CFR 402.130

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-711 Request for Deceased Individual's Social Security Record SSA-711 (revised).pdf No   Fillable Printable

Income Security General Retirement and Disability

 

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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 123 0 0 0 0 123
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-711 (current) SSA-711 (current).pdf 10/17/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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