OMB control number
Statement of Death by Funeral Director and State Death Match
OMB 0960-0142 · SSA.
The death of a beneficiary is an event that terminates the individual’s entitlement to Social Security benefits. As regulated, states must furnish death information to SSA to compare to SSA’s payment files. SSA employs two modalities for ensuring it efficiently receives accurate information regarding the deaths of SSA-insured workers and beneficiaries: (1) Form SSA–721, Statement of Death by Funeral Director; and (2) the Electronic Death Registration (EDR). SSA operates the State Death Match collections, which includes the EDR process for electronically reporting death records to SSA. The states furnish death certificate information to SSA via a manual registration process (the SSA-721), or via the EDR Registration Process. Both death match processes are automated electronic transfers between the states and SSA. This collection, via paper form SSA-721 or the EDR, allows for the funeral director or funeral home responsible for the individual’s burial or cremation to report the death to SSA. SSA uses this information for three purposes: (1) to establish proof of death for the insured worker; (2) to determine if the insured individual was receiving any pre-death benefits SSA needs to terminate; and (3) to ascertain which surviving family member is eligible for the lump-sum death payment or for other death benefits. The respondents for this information collection are funeral directors who handled death arrangements for the insured individuals, and the states’ bureaus of vital statistics.
The latest form for Statement of Death by Funeral Director and State Death Match expires 2027-07-31 and can be found here.
Document Name |
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Form and Instruction |
Supplementary Document |
Supporting Statement A |
Report of Death by Funeral Director
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form SSA-721 | Statement of Death by Funeral Director | www.ssa.gov | Form and instruction |
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