Use Form SSA-1724-F4 for a deceased beneficiary who may have been due a Social Security payment and/or a Medicare Premium refund prior to or at the time of death.
SSA-1724-F4: Claim for Amounts due in case of a Deceased Beneficiary
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Form SSA-1724-F4
SSA-1724-F4: Claim for Amounts due in case of a Deceased Beneficiary FAQs
What is Form SSA-1724-F4?
Form SSA-1724-F4 is used for a deceased beneficiary who may have been due a Social Security payment and/or a Medicare Premium refund prior to or at the time of death.
Where do I submit Form SSA-1724-F4?
Send your completed Form SSA-1724-F4 to your local Social Security office.
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