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OMB Approved No. 29000695 Respondent Burden: 15 Minutes Expiration Date: 02/28/2025APPLICATION FOR REIMBURSEMENT OF LICENSING OR CERTIFICATION TEST FEESIMPORTANT: Complete this application to apply
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Visit the official website where the online form for survivors and dependents is available.
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Create an account if required or log in with your existing credentials.
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Locate the form for survivors and dependents and click on it.
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Fill in all the required fields accurately, including personal information and details of the deceased or primary account holder.
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Upload any necessary documents or proof of dependency as instructed.
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Who needs online survivors and dependents?

01
Survivors and dependents of deceased individuals who were receiving benefits or support from an organization or institution.
02
Those who are eligible for continued financial assistance or other benefits as a result of the passing of the primary account holder.
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Online survivors and dependents refer to a process or form used to apply for benefits or assistance available to the survivors and dependents of individuals, typically in the context of Social Security or insurance.
Individuals who are survivors or dependents of a deceased person who was eligible for certain benefits, such as Social Security benefits, are required to file online survivors and dependents.
To fill out online survivors and dependents, you need to visit the designated government website, create an account or log in, complete the required personal information, provide details about the deceased, and submit any necessary documentation.
The purpose of online survivors and dependents is to streamline the application process for benefits that are owed to the eligible relatives or dependents after the death of an individual, ensuring they receive necessary financial support.
Information that must be reported includes the deceased individual's personal details (name, Social Security number, dates of birth and death), the relationship of the applicant to the deceased, and financial information regarding the dependent or survivor.
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