Organizations to be Contacted
Name of organization: ______________________________________________________________________________________
Contact person: _________________________________________________Phone: ___________________________________
Name of organization: ______________________________________________________________________________________
Contact person: _________________________________________________Phone: ___________________________________
Name of organization: ______________________________________________________________________________________
Contact person: _________________________________________________Phone: ___________________________________
Name of organization: ______________________________________________________________________________________
Contact person: _________________________________________________Phone: ___________________________________
Name of organization: ______________________________________________________________________________________
Contact person: _________________________________________________Phone: ___________________________________
Social Security Information
A lump sum Social Security payment may be made when an eligible person dies. This payment can only be made if there is an eligible surviving
widow, widower, or entitled child. Also, survivor’s checks may go to certain members of a worker’s family.
To facilitate receiving Social Security Benefits, you will need the following when you contact your or the Social Security Office:
1) Social Security Number
2) Marriage license
3) Children’s birth certificates
4) W2 for the previous 2 years
5) Proof of the widow(er)’s age if 62 years or older
6) Certified copy of death certificate
An application for the lump sum death payment usually must be made within two years after the worker’s death. Don’t delay applying because
you don’t have all the proof of information. The Social Security Office will tell you about other proof of information that can be used when you
apply.
It is a good idea to check your record every three years to make sure that earnings are being correctly reported to your record.
Social Security Administration
Toll-free phone number 1-800-772-1213
SSA.com
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