SSA-711

Request For Deceased Individual's Social Security Record

Download and Print the SSA-711

*Use This Form If You Need

1. Photocopy of Original Application for a Social Security Card (SS-5).
OR
2. Computer extract of Social Security Card Application.

“Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. §3507, as amended by Section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. We estimate that it will take about 7 minutes to read the instructions, gather the facts, and answer the questions. Send only comments on our time estimate above to: SSA, 1338 Annex Building, Baltimore, MD 21235-6401.”
INFORMATION ABOUT YOUR REQUEST

○ How Do I Get This Information?
Complete page 2 of this form to tell us what information you want. Photocopy page 2 for multiple requests.

○ Is There A Fee For This Information? Yes
Photocopy of Original Application for Social Security Card (SS-5)
If SSN of deceased individual is provided, the fee is $27.00. If SSN of deceased individual is not provided, the fee is $29.00.
Computer Extract of SS-5 (May not contain the names of the individual’s parents and the place of birth)
If SSN of deceased individual is provided, the fee is $16.00. If SSN of deceased individual is not provided, the fee is $18.00.
Certified copy is provided for an additional fee of $10.00 (See instructions below)

○ SSN Search required.
Complete as much information as possible in Blocks 4 and 5, if the deceased individual’s SSN is unknown.

○ When Is Certification required? Certification is usually not necessary unless you plan to use the information in court.

○ Method of Payment.
Payment can be made with a credit card by completing the attached Form SSA-714 and returning it with your request(s) form. You may also pay with a check or money order (Name, Address and Phone Number must appear on Check). Enclose one check or money order for the entire fee required (total from request(s)). DO NOT SEND CASH.

And much more...