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___ Name___ DateSurviving the Survivor Gap Will you need to replace lost retirement income if your spouse dies? If you died, could your spouse:When it comes to retirement, what sources of income do
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Gather all necessary information required to fill out the form such as personal details, contact information, relationship to the survivor, and details of the incident.
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Who needs form survivor gap?

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Anyone who is a survivor of a traumatic event and is seeking support or assistance.
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Form survivor gap is a form used by eligible survivors of deceased federal employees or retirees to claim survivor benefits.
Beneficiaries who are eligible to receive survivor benefits from deceased federal employees or retirees are required to file form survivor gap.
Form survivor gap can be filled out by providing personal information, relationship to deceased, details of deceased federal employee or retiree, and other relevant information.
The purpose of form survivor gap is to allow eligible survivors to claim survivor benefits from deceased federal employees or retirees.
Information such as personal details, relationship to deceased, details of deceased federal employee or retiree, and other relevant information must be reported on form survivor gap.
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