Form SSA-11-BK, Request to Be Selected as Payee

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What is an SSA 11 BK Form?

It is an extensive ten-page application for a payee placeholder appointment. To fill it out, you will need to provide evidence that a recipient of Social Security benefits cannot manage them on their own and really needs an official representative. Getting a power of attorney is not enough for such purposes.

Form SSA-11-BK on PDFLiner

What do I need the Form SSA 11 BK for?

  • You can use the Social Security Administration Form SSA 11 BK to claim yourself as an official payee.
  • Beneficiaries, that is, benefits recipients, can be minor children or adults who, for certain reasons, are officially recognized as unable to handle their payments.
  • You cannot receive benefits instead of a recipient unless you complete this form and receive an official designation from SSA.

How to Fill out SSA-11-BK?

  1. Enter the personal information of the beneficiary and the person who claims to be a payee.
  2. Answer a few questions clarifying the beneficiary's situation and need for an official representative.
  3. Then provide more detailed information about you as the applicant; in particular, indicate your sources of income, the presence/absence of a criminal record, and so on.
  4. Carefully read the description of the payee's responsibilities and what to do if the beneficiary's health changes or they die. In particular, according to the SSA-11-BK printable form, you are required to regularly report on how you manage the money received.
  5. Enter your name and put your signature as an agreement to all the conditions.

Form SSA-11-BK on PDFLiner

Organizations that work with SSA 11 BK Form PDF

  • SSA
Fillable online Form SSA-11-BK, Request to Be Selected as Payee
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