RSA SB PRDB, Application for Survivor Benefit


State: Alabama
Category: Retirement
Format: PDF
Form Name: RSA SB PRDB Application for Survivor Benefit.pdf

(The pdf reader is necessary.)

Form Instructions:

 

INSTRUCTIONS: ALABAMA APPLICATION FOR SURVIVOR BENEFIT

 

 

Survivors of deceased members of the Alabama Employees' Retirement System or Teachers' Retirement System can file the form discussed in this article to receive their benefits. The document can be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Application For Survivor Benefit Step 1: Indicate whether the deceased was a members of the Employees' Retirement System or Teachers' Retirement System by filling in the oval next to the applicable statement.

 

Alabama Application For Survivor Benefit Step 2: On the first blank line, enter the full name of the deceased.

 

Alabama Application For Survivor Benefit Step 3: On the second blank line, enter the Social Security number of the deceased.

 

Alabama Application For Survivor Benefit Step 4: On the third blank line, enter the date of birth of the deceased.

 

Alabama Application For Survivor Benefit Step 5: On the fourth blank line, enter the date of death of the deceased.

 

Alabama Application For Survivor Benefit Step 6: On the fifth blank line, enter the employing agency of the deceased.

 

Alabama Application For Survivor Benefit Step 7: On the sixth blank line, enter the full name of the surviving beneficiary.

 

Alabama Application For Survivor Benefit Step 8: On the seventh blank line, enter the date of birth of the beneficiary.

 

Alabama Application For Survivor Benefit Step 9: On the eighth blank line, enter the relationship to the deceased of the beneficiary.

 

Alabama Application For Survivor Benefit Step 10: On the ninth blank line, enter the Social Security number of the beneficiary.

 

Alabama Application For Survivor Benefit Step 11: On the tenth blank line, enter the telephone number of the beneficiary.

 

Alabama Application For Survivor Benefit Step 12: On the eleventh blank line, enter the complete address of the beneficiary.

 

Alabama Application For Survivor Benefit Step 13: In Part II, the beneficiary should sign and date the form. 

 

Alabama Application For Survivor Benefit Step 14: The beneficiary should have the remainder of Part II completed by a notary public.

 

Alabama Application For Survivor Benefit Step 15: Part III should be completed by the payroll official of the employer of the deceased.

 

Alabama Application For Survivor Benefit Step 16: File this return by mailing it to the address at the top of the page. A certified original death certificate must be attached.

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