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SSA Retirement, Dependent & Survivors Forms

Quickly access the forms to file an application for Social Security Disabled Widow(er)s, Disabled Surviving Divorced Spouses and Childhood Disability benefits.

When filing a disability claim on the Social Security account of a worker who is receiving Social Security disability or retirement benefits or on the account of a worker who has died, the base form that is used is the same as the application form for a non-disabled dependent or survivor. For disabled widows, widowers, and surviving divorced spouses, the form is the SSA-10. For disabled adult children (who became disabled before age twenty-two) the application for Childhood Disability Benefits is the SSA-4-BK.

Both these application forms, the SSA-10 and the SSA-4-BK, need to be supported with the same medical and vocational statements and authorization as a disabled worker’s application. You will also find other applications and reporting forms for Social Security claimants who are not disabled.

Please click on a link below to open your desired form in a separate browser window. 

SSA-1-BK Application for Retirement Insurance Benefits

SSA-2-BK Application for Wife’s or Husband’s Insurance Benefits

SSA-3 Marriage Certification

SSA-4-BK Application for Child’s Insurance Benefits

SSA-5-BK Application for Mother’s or Father’s Insurance Benefits

(for parent with child in care)

SSA-7-F6 Application for Parent’s Insurance Benefits

(for dependent parent)

SSA-8 Application for Lump-Sum Death Payment

SSA-10 Application for Widow’s or Widower’s Insurance Benefits

SSA-25 Certification of Election for Reduced Spouse’s Benefits

SSA-2519 Child Relationship Statement

SSA-4111 Certification of Election for Reduced Widow(er)’s/Surviving Divorced Spouse’s Benefits

SSA-1383 Advanced Notice of Termination of Child’s Benefits

(for continuation of benefits while age 18 and in school up to grade 12.

SSA-1945 Student Reporting Form

(to report change in student status or other terminating events)