Please note that this form has two sections.  The first section is for information about the deceased individual and the second section has information about the individual submitting the claim. 

Below are also instructions regarding the documents you will need to upload when filling out this form. Depending on your relationship to the deceased individual, you will need to upload the following documents:

Marriage Certificate - for spouses of deceased individual

Birth Certificate - for children of deceased individual

Supporting documentation - showing relationship to the deceased and/or justification for the claim.

Regardless of your relationship to the deceased individual, all individuals submitting a claim will be required to upload the following documents:

Government issued ID, Death Certificate, Notarized Affidavit, IRS W-9 form