Form SSA-1724-F4, Claim for Amounts Due in Case of a Deceased Beneficiary is a form used for claiming Social Security payments or Medicare Premium refund that a deceased beneficiary may have been due prior or at the time of death.
The form - also known as the SSA Form 1724-F4 or the Social Security deceased beneficiary form - was issued by the Social Security Administration (SSA). The latest version of the document was released in May 2016 with all previous editions still in use. An SSA-1724-F4 fillable form is available for download and digital filing below or on the SSA official website.
The person who claims payments should be a beneficiary's relative or legal representative of the estate. The SSA uses the information provided in this document to determine if the claimant is eligible to receive the Social Security payments. If you claim these benefits as a legal representative of the deceased person, attach a letter of appointment to your Form SSA-1724-F4.