Office of Personnel Management (OPM)


Report the Death of an Annuitant

Please enter the information below and press the Submit button. Note: Form fields which are required will be noted with this icon " " or the message that "This field is required."

Enter identifying information about the retirement benefits record. If this information is not available, please call us.

Claim Number (include both the "A" or"F" prefix and the first seven numbers):
Name of Former Federal Employee (First, Middle Initial, Last):

Enter information about the deceased.

Date of Birth (MM/DD/YYYY):
Social Security Number (with dashes):
Name of Deceased (First, Middle Initial, Last):
Date of Death (MM/DD/YYYY):

Enter information about the surviving family member.

Survivor's Name (First, Middle Initial, Last):
Survivor's Social Security Number (with dashes):
Relationship to Deceased:
Survivor's Address:
Street Address
City and State
Zip Code
Telephone Number (with Area Code):		Call:
Email Address:
Additional Information:


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