Claim for Amounts Due in the Case of a Deceased Beneficiary

OMB 0960-0101

OMB 0960-0101

SSA requests applicants complete Form SSA-1724 when there is insufficient information in the file to identify the person(s) entitled to the underpayment, or the person's address. SSA collects the information when a surviving widow(er) is not already entitled to a monthly benefit on the same earnings records, or is not filing for a lump-sum death payment as a former spouse. SSA uses the information Form SSA-1724 provides to ensure proper payment of an underpayment due a deceased beneficiary. The respondents are applicants for underpayments owed to deceased beneficiaries. We are making non-substantive changes so that we can use the form for both Title II underpayments and Title XVIII Medicare premium refunds.

The latest form for Claim for Amounts Due in the Case of a Deceased Beneficiary expires 2021-08-31 and can be found here.

All Historical Document Collections
Approved with change
Revision of a currently approved collection 2021-06-25
Approved without change
Revision of a currently approved collection 2018-05-10
Approved without change
No material or nonsubstantive change to a currently approved collection 2015-12-30
Approved without change
Extension without change of a currently approved collection 2015-04-28
Approved without change
Revision of a currently approved collection 2012-07-19
Approved without change
Revision of a currently approved collection 2009-07-16
Approved without change
No material or nonsubstantive change to a currently approved collection 2009-01-16
Approved with change
Revision of a currently approved collection 2006-06-15
Approved without change
Extension without change of a currently approved collection 2003-06-26
Approved without change
Extension without change of a currently approved collection 2000-05-03
Approved without change
Extension without change of a currently approved collection 1997-06-13
Approved without change
Extension without change of a currently approved collection 1994-04-06
Approved without change
Extension without change of a currently approved collection 1991-02-06
Approved without change
Extension without change of a currently approved collection 1990-02-15
Approved with change
No material or nonsubstantive change to a currently approved collection 1989-04-21
Approved without change
Extension without change of a currently approved collection 1987-03-11
Approved without change
Revision of a currently approved collection 1984-04-10
Approved without change
Extension without change of a currently approved collection 1984-01-27
Approved without change
Revision of a currently approved collection 1980-12-31
Approved without change
Revision of a currently approved collection 1976-10-19

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