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Instructions for the Claim for Unpaid Compensation of Deceased Member of the Uniformed Services (SF 1174)

When to use this form:
 

The SF 1174 should be completed to make a claim for monies due to an annuitant after their death. After an annuitant has passed, if there is any money due to the account it will be paid according to the federal Order of Precedence. Unlike retirees, annuitant's do not keep a designated beneficiary on file. So, the Order of Precedence is used to determine who is entitled to the annuitant's final payment.

Listed below are instructions for the most common claimants to the annuitant's Arrears of Pay. The instructions are broken into relationship based on the Order of Precedence.

Please note the end of this document has supplemental instructions for those claimants with special circumstances; additional documentation or steps may be required.

The completed SF 1174 should be returned with a copy of the Death Certificate that lists the cause of death and mailed to:

Defense Finance and Accounting Service
Retired and Annuitant Pay
P.O. Box 7131
London, KY 40742-7131
 

The following instructions outline how to complete an SF 1174 for the following:

Spouse, Children, Parents

Part

Instructions

Reminder or Tips

A

Complete Sections # 1- 6 with your information and,

Complete Sections # 7-10 with information of the decedent

If claimant is minor, complete form DD 2790. (PDF 350 KB - 11/28/2005)

If claimant does not have a "Social Security Number," please complete IRS Form W-7. (PDF 263 KB - 1/29/2011)

B

Respond "Yes" if claimant was married to member at time of death

n/a

C

Complete by listing all Next of Kin information, following the Order of Precedence, until you've reached the relationship which your claim is being made.

If next of kin do not exist, which take precedence to your relationship, please indicate this.

Example: If you are a parent making claim, then "Spouse - Deceased"

"Children - N/A"

D

Complete with N/A

n/a

E

Funeral Expenses - Respond with N/A

1. Claims must be signed, include mailing address, dated, and witnessed by two disinterested parties to be considered valid.

2. If claimant has a Power of Attorney/attorney in fact please see instructions at supplemental instructions at the end of this document.

3. If claimant is not child and address is "foreign," please complete IRS Form W-8, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding

Sign & Date your name where it indicates "signature of claimant." Under your signature provide your address and phone number.

Enter your name in the witness section where it says "Name(s) of claimant(s)."

Have two witnesses sign their name and enter their address.

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Estate

  • Any claims made on behalf of an Estate must be accompanied by a court-ordered appointment naming the Executor of the Estate.

Part

Instructions

Reminder or Tips

A

Complete Sections # 1- 6 with information of "Estate of"/Executor or and,

Complete Sections # 7-10 with information of the decedent

Claims made on behalf of an Estate require an Employer Identification Number (EIN) instead of a Social Security Number.

B

Complete with N/A

n/a

C

Complete by listing all Next of Kin information, following the Order of Precedence, until you've reached the relationship which your claim is being made.

If next of kin do not exist, which take precedence to your relationship, please indicate this.

Example: If you are a parent making claim, then "Spouse - Deceased"

"Children - N/A"

D

Complete by listing information regarding the Estate and provide contact information for the executor or those whose behalf the Executor are acting.

Court appointed documentation is required as proof of your authority

E

Complete funeral expenses

1. Claims must be signed, include mailing address, datedand witnessed by two disinterested parties to be considered valid.

2. If co-executors exist, both parties must sign the SF1174 claim form

Sign & Date your name where it indicates "signature of claimant." Under your signature provide your address and phone number.

Witness signatures are not needed for claims made on behalf of Estate

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Payee of the Funeral Bill

  • Any claims being made as payee of the funeral bill must be accompanied by a copy of the funeral bill, a copy of the cancelled check or credit card receipt. Payee of funeral payment must match that of the claimant. Ex: One cannot claim arrears for a funeral paid for with the decedent's money.
  • Front and back of the check is needed. If a credit card was used then a statement from the credit card is needed to show the deductions were taken out of the " claimant's" account. Or a receipt with the payee's name with the corresponding transaction.

Part

Instructions

Reminder or Tips

A

Complete Sections # 1- 6 with your information and,

Complete Sections # 7-10 with information of the decedent

If claimant does not have a "Social Security Number," please complete IRS Form W-7. (PDF 263 KB - 1/29/2011)

B

Complete with N/A

n/a

C

Complete by listing all Next of Kin information, following the Order of Precedence, until you've reached the relationship which your claim is being made.

If next of kin do not exist, which take precedence to your relationship, please indicate this.

Example: If you are a parent making claim, then "Spouse - Deceased"

"Children - N/A"

D

Complete by listing information regarding the Estate and provide contact information for the executor or those whose behalf the Executor are acting.

If you are the court appointed Executor of the estate, please follow instructions for " Not Designated Estate" - as the Estate takes precedence over Payee of Funeral Bill

E

Complete funeral expenses

Your name must match those shown on the funeral payments in order to collect arrears of pay.

Sign & Date your name where it indicates "signature of claimant." Under your signature provide your address and phone number.

1. Claims must be signed, include mailing address, dated, and witnessed by two disinterested parties to be considered valid.

2. If claimant has a Power of Attorney/attorney in fact please see supplemental instructions at the end of this document.

3. If claimant's address is "foreign," please complete IRS Form W-8, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding

Enter your name in the witness section where it says "Name(s) of claimant(s)."

Have two witnesses sign their name and enter their address.

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Siblings, Children of Siblings

Part

Instructions

Reminder or Tips

A

Complete Sections # 1- 6 with your information and,

Complete Sections # 7-10 with information of the decedent

If claimant is minor, complete form DD 2790. (PDF 350 KB - 11/28/2005)

If claimant does not have a "Social Security Number," please complete IRS Form W-7. (PDF 263 KB - 1/29/2011)

B

Complete with N/A

n/a

C

Complete by listing all Next of Kin information, following the Order of Precedence, until you've reached the relationship which your claim is being made.

If next of kin do not exist, which take precedence to your relationship, please indicate this.

Example: If you are a parent making claim, then "Spouse - Deceased"

"Children - N/A"

D

Complete by listing information regarding the Estate and provide contact information for the executor or those whose behalf the Executor are acting.

If you are the court appointed Executor of the estate, please follow instructions for " Not Designated Estate " - as the Estate takes precedence over siblings/children of siblings.

E

Complete funeral expenses

If your money was used to pay funeral expenses, please follow instructions for " Payee of Funeral Bill "

Sign & Date your name where it indicates "signature of claimant." Under your signature provide your address and phone number.

1. Claims must be signed, include mailing address, dated, and witnessed by two disinterested parties to be considered valid.

2. If claimant has a Power of Attorney/attorney in fact please see supplemental instructions the end of this document.

3. If claimant's address is "foreign," please complete IRS Form W-8, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding

Enter your name in the witness section where it says "Name(s) of claimant(s)."

Have two witnesses sign their name and enter their address.

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Supplemental Instructions for Claimant with Special Circumstances

Minor Child or Beneficiary with Legal Guardian (GDN)

Example of completed form (PDF 568 KB - 12/15/2011)

  1. Your claim must be accompanied by a completed copy of DD 2790 (PDF 350 KB - 11/28/2005)
  2. Part E must be signed by your Legal Guardian with their contact information

Beneficiary with a Power of Attorney (POA)

Example of completed form (PDF 318 KB - 2/15/2011)

  1. Your claim must be accompanied by your Power of Attorney paperwork
  2. Part E must be signed by your Power of attorney with their contact information

Beneficiary with Foreign Address

Example of completed form (PDF 378 KB - 2/15/2011)

  1. Children of retiree's do not need to fill out a citizenship affidavit
  2. All others with an address outside of the United States are required to submit an . IRS Form W-8, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding
  3. If you do not have a social security number you will need to obtain one from the IRS by completing the IRS Form W-7 (PDF 263 KB - 1/29/2011)

Multiple Beneficiaries Using the Same Form

Example of completed form (PDF 366 KB - 2/15/2011)

  1. Both names and SSN should be provided in PART A
  2. All beneficiaries should be listed in PART C
  3. A maximum of two beneficiaries can be used on each form in PART E
  4. Both names should be listed in the witness section in PART E

Please return all documents to:
Defense Finance and Accounting Service
Retired and Annuitant Pay
P.O. Box 7131
London, KY 40742-7131

Please direct questions to the address above or call our customer service representatives at 800-321-1080, between 7 a.m. and 7:30 p.m. Eastern Time, Monday through Friday.

Page Updated: May 4, 2011