Updated October 19, 2026. Quick answer: Form SSA-1724-F4 is the Claim for Amounts Due in the Case of a Deceased Beneficiary. It is how next of kin or the legal representative of the estate claims a Social Security payment or Medicare premium refund the person was owed at death. The form follows the order of who is paid: a surviving widow or widower first, then children, then parents, then the legal representative with certified letters of appointment.
Quick reference
| Item | As printed on the form |
|---|---|
| What the form is | Claim for a Social Security payment or Medicare premium refund owed at death |
| Item 1 | Surviving widow or widower; if living in the same household or entitled, skip items 2 to 5 |
| Item 2 | Living children, including adopted children and stepchildren |
| Item 4 | Living parents, including adopting parents and stepparents |
| Item 5 | Legal representative of the estate, with certified letters of appointment |
| Pages | 3 |
| Time to complete | About 10 minutes, per the form |
| Help | 1-800-772-1213 (TTY 1-800-325-0778) |
What the money is
The form describes what may be owed: “The deceased may have been due a Social Security payment and/or a Medicare Premium refund.”
It then says who can be paid: “The Social Security Act provides that amounts due a deceased may be paid to the next of kin or the legal representative of the estate under priorities established in the law.” This is separate from the lump-sum death payment, which has its own application in Form SSA-8 and is explained at the Social Security death benefit.
| Related survivor item | From Social Security’s survivors booklet |
|---|---|
| Lump-sum death payment | $255, a separate application |
| Deadline for the lump-sum payment | 2 years from the date of death |
| Monthly survivors benefits can start | As early as age 60 for a surviving spouse, age 50 if disabled |
“If you’ve worked long enough, we make a one-time payment of $255 when you die.” “Survivors must apply for this payment within 2 years of the date of your death.” “Your surviving spouse can get reduced benefits as early as age 60.” “If your surviving spouse has a disability, benefits can begin as early as age 50.”
Who is paid first: the order of the items
Item 1 asks for the surviving widow or widower, with a name, address and Social Security number, and two questions: whether that person lived in the same household with the deceased at death, and whether they were entitled to a monthly benefit on the same earnings record. A yes to either means you skip items 2 to 5 and sign.
If not, Item 2 lists living children. The form says to “INCLUDE ADOPTED CHILDREN AND STEPCHILDREN; INCLUDE GRANDCHILDREN AND STEP-GRANDCHILDREN IF THEIR PARENTS ARE DISABLED OR DECEASED” Item 3 explains name changes; Item 4 lists living parents, including adopting parents and stepparents.
The estate’s legal representative
Item 5 is the last stop: “LEGAL REPRESENTATIVE OF THE DECEASED’S ESTATE (Skip this item if relatives are listed in 1, 2, or 4.)” An executor or administrator signs here and the form says “If you are applying as legal representative, please submit a certified copy of your letters of appointment.”
For an estate this is one stop in a longer list. Our deadlines after a death calculator and unclaimed property after a death page cover the others, and checks made out to a deceased person covers what to do when one arrives.
Signing, deposit and what to send
The applicant prints their name and relationship to the deceased, gives the date of death and the state where the deceased lived, and signs under penalty of perjury with date, telephone and address. A block takes direct deposit details: the financial institution, checking or savings, a nine digit routing number and the account number. The form says “WITNESSES ARE REQUIRED ONLY IF THIS APPLICATION HAS BEEN SIGNED BY MARK (X) ABOVE.”
The form is designed to be returned in the envelope Social Security encloses, and the instructions ask you to complete the entire form so the agency can decide who should receive the payment. If the payment is owed and no one has sent you the form, call 1-800-772-1213.
The edition read for this page is Form SSA-1724-F4 (10-2024) as the agency served it on 2026-10-19. Check the edition printed on the copy you use, because a later edition can change the questions, the mailing instructions and the evidence asked for.
Common mistakes
- Filling in items 2 to 5 when the surviving spouse lived with the deceased or was entitled on the same record. The form tells you to skip them and sign.
- Sending as executor without a certified copy of the letters of appointment.
- Leaving a child off the list. The form asks for adopted children, stepchildren and, in some cases, grandchildren.
- Confusing this claim with the lump-sum death payment. They are different payments on different forms.
Related: Form SSA-8, the Social Security death benefit, the surviving spouse checklist, and Social Security and Medicare forms.
Sources
- Form SSA-1724-F4 (10-2024), Claim for Amounts Due in the Case of a Deceased Beneficiary: https://www.ssa.gov/forms/ssa-1724.pdf
- SSA Publication 05-10084 (April 2026), Survivors Benefits: https://www.ssa.gov/pubs/EN-05-10084.pdf
Read from the Social Security Administration and Centers for Medicare and Medicaid Services documents linked above on October 19, 2026. General information, not legal or benefits advice. Your own facts decide the outcome, and Social Security at 1-800-772-1213 is the right place to confirm anything consequential.