410.221—Prescribed application and request forms.

(a) Claims shall be made as provided in this subpart on such application forms and in accordance with such instructions (provided thereon or attached thereto) as are prescribed by the Administration.
(b) The application forms used by the public to file claims for benefits under part B of title IV of the Act are SSA-46 (application for benefits under the Federal Coal Mine Health and Safety Act of 1969 (coal miner's claim of total disability)), SSA-47 (application for benefits under the Federal Coal Mine Health and Safety Act of 1969 (widow's claim)), SSA-48 (application for benefits under the Black Lung Benefits Act of 1972 (child's claim)), and SSA-49 (application for benefits under the Black Lung Act of 1972 (parent's, brother's, or sister's claim)).
(c) The form used by an individual to request that such individual be selected as a representative payee or by a dependent to request that payment be certified to him separately is SSA-50 (Request to be Selected as Payee).
(d) For further information about some of the forms used in the administration of part B of title IV of the Act, see §§ 422.505(b), 422.515, 422.525, and 422.527 of this chapter.

Code of Federal Regulations

[37 FR 20637, Sept. 30, 1972]