OMB control number
Application for Child's Insurance Benefits
OMB 0960-0010 · SSA.
Title II of the Social Security Act (Act) provides for the payment of monthly benefits to children of an insured retired, disabled, or deceased worker. Section 202(d) of the Act discloses the conditions and requirements the applicant must meet when filing an application. An unmarried child who has a parent who is retired or has a disability and is entitled to Social Security benefits, or who has a parent who died after having worked long enough in a job where they paid Social Security taxes, is entitled to receive benefits. An unmarried child can receive benefits if they meet one of the following criteria: (1) the child is younger than 18; (2) the child is a full-time student at an elementary or secondary school (grade 12 or below); (3) the child is age 18 to 19 and attending elementary or secondary school full-time; or (4) the child is age 18 or older with a disability that began before age 22. Under certain circumstances, SSA can also pay benefits to a stepchild, grandchild, step-grandchild, or adopted child. Respondents can download and complete Form SSA 4 BK at www.ssa.gov and mail it back to SSA, or they can call SSA to schedule an appointment at the field office, where an SSA employee can interview respondents and enter information into our Modernized Claims Systems (MCS). When applying for benefits for a child, the respondent needs to provide SSA with the following information: (1) the child’s birth certificate or other proof of birth or adoption; and (2) the parent’s and child’s Social Security numbers. Depending on the type of benefit involved, SSA may require other documents for example: if applying for survivors benefits for the child, SSA requires proof of the parent’s death; and if applying for benefits for a child with a disability, SSA requires medical evidence to prove the child’s disability. The SSA representative helping the respondent with their application tells them what other documents they may need, or the respondent can find the information on SSA’s website. SSA uses the information on Form SSA-4-BK to determine entitlement for children of living and deceased workers to monthly Social Security payments. The respondents are guardians completing the form on behalf of the children of living or deceased workers, or the children of living or deceased workers.
The latest form for Application for Child's Insurance Benefits expires 2026-06-30 and can be found here.
Document Name |
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Form |
Form |
Form |
Form |
Supplementary Document |
Supporting Statement A |
Application for Child's Insurance Benefits / Death Claim / SSA-4-BK
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form SSA-4-BK | Application for Child's Insurance Benefits | Paper Only | Form |
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