Proof of death 2026

1. Click ‘Get Form’ to open the proof of death document in the editor.
2. Begin by filling out Section A, which requires information about the deceased. Enter the deceased's name, relationship to the employee, social security number, birthdate, date of death, age, gender, and last residence details.
3. Proceed to Section B for information about the employee. Fill in their name, social security number, last residence details, birthdate, employment dates, and work location.
4. In Section C, provide details regarding the employee's coverage. Include employer's name and contact information along with any relevant insurance benefits being claimed.
5. Complete Section D by listing beneficiaries' information including names, addresses, relationships to the employee, and social security numbers.
6. Finally, review all sections for accuracy before submitting. Attach necessary documents as specified in Section F and send it via fax or mail as instructed.

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