The SSA-11-BK is the paper form a potential payee completes to apply to be payee.
Use the paper form only, when it is not possible to use eRPS. For example, we must take paper applications
for applicants who do not have a Social Security Number (SSN). If you appoint a payee
who does not have an SSN, you must update the Master Beneficiary Record (MBR), Supplemental
Security Record (SSR), or both with your payee selection via manual action (GN 00502.190).
To the extent practicable, complete the SSA-11-BK in a face-to-face interview and
retain a copy in the Non-Disability Repository for Evidentiary Documents (NDRED).
For instructions about telephone or video service delivery (VSD) interviews for undue
hardship or subsequent face-to-face interviews, see GN 00502.113B. For procedures on retaining the SSA-11-BK, see GN 00502.110. Faxed, mailed, or dropped off SSA-11-BK's are leads and you must follow up with
a face-to-face, telephone, or VSD interview.
If you take a SSA-11-BK because the system is temporarily unavailable, you must process
the application through eRPS when the system becomes available, see MS 07409.001.
If the recipient dies before you process the SSA-11-BK completely, handle the form
as incomplete, and notify the payee applicant of the action taken (GN 01010.475 and