Application for Lump-Sum Death Payment

OMB 0960-0013

SSA uses Form SSA-8 to collect information needed to authorize payment of the lump sum death payment (LSDP) to a widow, widower, or children as defined in section 202(i) of the Social Security Act (Act). Respondents complete the application for this one-time payment through use of the paper form, or person interview with an SSA employee either via telephone, or in person in a field office. For all personal interviews (either telephone or in-person), we collect the information in our electronic Modernized Claim System (MCS) or via our Intranet-based Preliminary Claims System (PCS) which mirrors the MCS screens. Respondents are applicants for the LSDP.

The latest form for Application for Lump-Sum Death Payment expires 2022-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SSA-8 Application for Lump-Sum Death Payment - Paper Form and Instruction
Addendum - 0013 (Final).docx Supplementary Document
Supporting Statement - 0013 (Final).docx Supporting Statement A
Application for Lump-Sum Death Payment - Paper Form and Instruction
Application for Lump-Sum Death Payment--Modernized Claims System (MCS) & Preliminary Claims System (PCS) Other-Internal Use Screens

All Historical Document Collections

202204-0960-010 Approved without change	Revision of a currently approved collection	2022-09-30
201904-0960-009 Approved without change	Revision of a currently approved collection	2019-08-07
201902-0960-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-02-13
201603-0960-004 Approved without change	Revision of a currently approved collection	2016-07-04
201303-0960-013 Approved without change	Revision of a currently approved collection	2013-07-19
201002-0960-004 Approved without change	Revision of a currently approved collection	2010-05-27
200805-0960-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-05-19
200609-0960-024 Approved without change	Revision of a currently approved collection	2007-02-20
200608-0960-019 Approved without change	No material or nonsubstantive change to a currently approved collection	2006-09-01
200401-0960-006 Approved without change	Extension without change of a currently approved collection	2004-01-28
200012-0960-002 Approved without change	Extension without change of a currently approved collection	2000-12-13
199709-0960-004 Approved without change	Extension without change of a currently approved collection	1997-09-11
199407-0960-008 Approved without change	Extension without change of a currently approved collection	1994-07-26
199105-0960-002 Approved without change	Extension without change of a currently approved collection	1991-05-20
198905-0960-003 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-05-02
198806-0960-002 Approved without change	Extension without change of a currently approved collection	1988-06-06
198507-0960-001 Approved without change	Revision of a currently approved collection	1985-07-03
198211-0960-006 Approved without change	Revision of a currently approved collection	1982-11-05
198110-0960-013 Approved without change	Revision of a currently approved collection	1981-10-28
198009-0960-003 Approved without change	Revision of a currently approved collection	1980-09-15
198002-0960-005 Approved with change	No material or nonsubstantive change to a currently approved collection	1980-02-25
197911-0960-002 Approved without change	Revision of a currently approved collection	1979-11-08
197909-0960-004 Approved with change	No material or nonsubstantive change to a currently approved collection	1979-09-28
197903-0960-021 Approved with change	No material or nonsubstantive change to a currently approved collection	1979-03-28
197809-0960-013 Approved with change	No material or nonsubstantive change to a currently approved collection	1978-09-28
197807-0960-003 Approved without change	Revision of a currently approved collection	1978-07-11
197804-0960-012 Approved with change	No material or nonsubstantive change to a currently approved collection	1978-04-07
197711-0960-009 Approved with change	No material or nonsubstantive change to a currently approved collection	1977-11-30

OMB Details

Application for Lump-Sum Death Payment - Paper

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-8

Application For Lump-Sum Death Payment

Fillable Printable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.