Statement of Death By Funeral Dire…
https://www.ssa.gov/forms/ssa-721.pdf
Document the confirmation of death assessment: A death certificate. (Generally, the funeral director provides a statement that can be used for this purpose.) Proof of the deceased worker's earnings for the previous year (W-2 forms or self-employment tax return). Your birth certificate. A marriage certificate, if you are applying for benefits as a surviving spouse or divorced spouse. Identity confirmed by wristband General inspection: no signs of life or respiratory effort No palpable central (carotid) pulse* No heart sounds on auscultation* No respiratory sounds on auscultation* Any other monitoring used to confirm cardiorespiratory arrest: continuous ECG monitoring, arterial line, echocardiography Absence of pupillary reflexes and corneal reflex Identity confirmed by wristband General inspection: no signs of life or respiratory effort No palpable central (carotid) pulse* No heart sounds on auscultation*
A death certificate. (Generally, the funeral director provides a statement that can be used for this purpose.)
Proof of the deceased worker's earnings for the previous year (W-2 forms or self-employment tax return).
Your birth certificate.
A marriage certificate, if you are applying for benefits as a surviving spouse or divorced spouse.
Identity confirmed by wristband
General inspection: no signs of life or respiratory effort
No palpable central (carotid) pulse*
No heart sounds on auscultation*
No respiratory sounds on auscultation*
Any other monitoring used to confirm cardiorespiratory arrest: continuous ECG monitoring, arterial line, echocardiography
Absence of pupillary reflexes and corneal reflex
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