Form SSA-5 | Information You Need To Apply for Mother's or Father's Benefits

You can apply for benefits by calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting your local Social Security office. An appointment is not required, but if you call ahead and schedule one, it may reduce the time you spend waiting to apply.

You can help by being ready to:

  • Provide any needed documents; and
  • Answer the questions listed below.

Documents you may need to provide

We may ask you to provide documents to determine if you may be eligible for benefits for having a child in your care:

  • Proof of the worker’s death;
  • Your birth certificate or other proof of birth;
  • Proof of U.S. citizenship or lawful alien status if you were not born in the United States [More Info];
  • U.S. military discharge paper(s);
  • W-2 form(s) and/or self-employment tax returns for last year.;
  • Proof of marriage;
  • Final divorce decree if applying as a surviving divorced mother or father; and
  • Child’s birth certificate or other proof of birth.

Important

We accept photocopies of W-2 forms, self-employment tax returns or medical documents, but we must see the original of most other documents, such as your birth certificate. We will return the documents to you.

Do not delay applying for benefits because you do not have all the documents. We will help you get them.

What we will ask you

  • Your name and Social Security number;
  • The deceased worker's name, date of birth, gender, and Social Security number;
  • The deceased worker’s date of death and place of death;
  • Your name at birth (if different) and any other names you have used;
  • Your date of birth and place of birth (City, State and/or foreign country);
  • Whether a public or religious record was made of your birth before age 5;
  • Your citizenship status;
  • Whether you have used any other Social Security number;
  • Whether you or anyone else has ever filed for Social Security benefits, Medicare or Supplemental Security Income on your behalf. (If so, we will also ask for information on whose Social Security record you applied);
  • Whether the deceased worker ever filed for Social Security benefits, Medicare or Supplemental Security Income. (If so, we will ask for information on whose Social Security record he or she applied.);
  • Whether you or the deceased worker were ever in the active military service before 1968 or ever worked for the railroad industry. (If so, we will ask you for the dates of services.);
  • Whether you became unable to work because of illnesses, injuries or conditions at any time within the past 14 months. If "Yes," we will also ask the date you became unable to work;
  • Whether the deceased worker was disabled at the time of death. (If so, we will ask when the disability began.);
  • Whether the deceased worker has a surviving parent who was dependent on the worker for 1/2 of his or her support at the time of the worker's death. (If “Yes”, the name and address of the parent.);
  • Whether you or the deceased worker have earned Social Security credits under another country's Social Security system;
  • Whether the deceased worker was a civilian employee of the Federal Government in January 1983;
  • Whether you qualified for or expect to receive a pension or annuity based on your own employment with the Federal government of the United States or one of its States or local subdivisions;
  • The names, dates of birth (or age) and Social Security numbers (if known) of your former spouses or and the deceased worker's former spouses;
  • The dates and locations of your marriages, and for marriages that have ended, how, when, and where they ended;
  • The dates of the deceased worker's marriages and how, when, and where they ended;
  • The names of the deceased worker’s children under age 18, age 18 to 19 and attending elementary or secondary school, or disabled before age 22;
  • The names and Social Security numbers of the deceased worker’s unmarried children under 16 or 16 and older and disabled before age 22 in your care and the months the child lived with you;
  • Whether the deceased worker had earnings last year or this year. (If yes, we will ask the amount.);
  • The amount of your earnings for this year, last year, and next year;
  • Whether you and the deceased worker were living together at the time of death; and
  • If you are within 3 months of age 65, whether you want to enroll in Medicare Part B (Medical Insurance).

Depending on the information you provide, we may need to ask other questions.

Note

You also should have with you your checkbook or other papers that show your account number at a bank, credit union or other financial institution so you can sign up for Direct Deposit, and avoid worries about lost or stolen checks and mail delays.