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Federal forms, ICRs, and supporting documents

OMB control number

Report of Deceased Individual's Social Security Record

OMB 0960-0665 · SSA.

OMB 0960-0665

When a member of the public requests a Social Security record, SSA needs the name and address of the requestor as well as a description of the requested record to process the request. SSA uses the information the respondent provides on Form SSA-711, or via an Internet request through SSA’s electronic Freedom of Information Act Xpress (FOIAXpress) website, to: (1) verify the wage earner is deceased; and (2) access the correct Social Security record. Respondents learn of the possibility for these requests via Agency mailers; multi-media commercials and advertising; SSA’s general website; a link from the mySocial Security landing page; as well as from other individuals. SSA is constantly reviewing our outreach tactics to assure maximum exposure and accessibility to all individuals who need this service. Our website and mailers list the information respondents need to apply for requests. Respondents are members of the public requesting deceased individuals’ Social Security Records.

The latest form for Report of Deceased Individual's Social Security Record expires 2028-03-31 and can be found here.

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Supporting Statement A
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OMB Details

Deceased Individual's Social Security Records, SSA-711 (Paper Form)

Federal Enterprise Architecture: Income Security - General Retirement and Disability

Form SSA-711Request for Deceased Individual's Social Security Recordwww.ssa.govForm

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