Section A: the deceased
Name, date of birth, date of death, Social Security Number, other names, CSA number if retired, any workers' compensation claim, employment status at death, and current and former spouses.
SF3104
Application for Death Benefits - FERS
- Agency
- GSA
- Revision
- Revised May 2013
- Fillable fields
- 223
- Pages
- 8
- Official source
- GSA form page
- Checked
- October 20, 2026
Standard Form 3104 (SF 3104): Application for Death Benefits (FERS)
Standard Form 3104 (SF 3104), Application for Death Benefits, Federal Employees Retirement System, is a U.S. Office of Personnel Management (OPM) form, Revised May 2013, OMB number 3206-0172. GSA hosts a copy in its forms library.
The form says it is for persons applying for benefits which may be payable under FERS because of the death of an employee, former employee or retiree who was covered by FERS. It refers to the pamphlet SF 3114, Applying for Death Benefits Under the Federal Employees Retirement System. The PDF also includes SF 3104A, Survivor Supplement, for the surviving spouse of a retiree.
The application has Sections A to K: the deceased, the applicant, the spouse, a former spouse, dependent children, other heirs, the estate, military service, payment instructions, certification and a checklist. OPM estimates an average of 60 minutes per response. You can fill it out free in your browser on this page and download the result without an account.
What's on SF 3104
Sections B to D: applicant and spouses
Your details and the basis of your claim, then the marriage for a widow(er), or the marriage, divorce, any court order, health benefits and remarriage for a former spouse.
Sections E to G: children, heirs and estate
Unmarried dependent children in order of birth, any child not yet born, Social Security applications for the children, other relatives who can inherit, and any executor or administrator.
Section H: active military service
For a spouse or former spouse, the deceased's branch and dates of active duty, any deposit for service after 12/31/56, military retired pay and military survivor benefits.
Sections I to K: payment, signature, checklist
Direct deposit or Direct Express details, the certification with signature, address and phone, and a checklist of documents such as the death and marriage certificates.
SF 3104A: Survivor Supplement
For a surviving spouse of a retiree who is under age 60, with questions about disability and Social Security mother, father or disability benefits.
How to complete SF 3104
- 1
Type or print in ink
The instructions say to type or print clearly in ink. If you do not know an answer, write "unknown". If you are unsure, answer as best you can followed by a question mark.
- 2
Add sheets for more space
Use plain paper with your name, date of birth and Social Security Number, and the deceased person's name, date of birth and Social Security Number, written at the top.
- 3
Mark the status in item 8
Employee, former employee or retiree. For an employee, the form points to SF 3104B from the former employing agency. For a retiree, a surviving spouse completes SF 3104A.
- 4
Attach the documents
Section K lists them, including a certified copy of the death certificate in all cases, marriage certificates for a spouse, and court papers for an executor, administrator or guardian.
- 5
Choose how payments are sent
Section I asks for direct deposit to a checking or savings account or a Direct Express debit card. A cancelled personal check can be attached instead of the bank details.
- 6
Sign Section J
The applicant named in Section B signs in ink, certifying the statements are true and that no evidence relating to the claim is withheld, and adds a mailing address and phone.
Why fill Form SF3104 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes and what the form says
Deceased was an employee
The form says to send the application, with any requested attachments, to the personnel office in the agency where the deceased was last employed.
Deceased was a former employee or annuitant
The form says to send it to OPM, FERS, P.O. Box 45, Boyers, PA 16017-0045.
Questions and the pamphlet
The form gives OPM's Retirement Information Office at 1-888-767-6738 and says SF 3114 is at www.opm.gov/retirement-services/publications-forms/.
Children and Social Security
The instructions say FERS benefits to children are not paid until OPM has verification of their Social Security entitlement or lack of it, and that leaving out SSA's notice may delay processing.
False statements
The form warns that an intentionally false or misleading statement is punishable by a fine of not more than $10,000 or imprisonment of not more than 5 years or both (18 USC 1001).
Related forms
SF3104B
Documentation and Elections in Support of Application for Death Benefits when Deceased was an Employee at the Time of Death (FERS)
290 fields, 18 pages
SF3102
Designation of Beneficiary - Civil Service and Federal Employees Retirement Systems
34 fields, 3 pages
SF2800
Application for Death Benefits - Civil Service Retirement System
204 fields, 7 pages
SF2800A
Documentation and Elections in Support of Application for Death Benefits When Deceased was an Employee at the Time of Death - Civil Service Retirement System
258 fields, 8 pages
Who fills out SF 3104?
Item 5 of Section B lists the ways an applicant can apply.
Official sources and the blank
Do it all with indox
No tool matches that search.
Questions about Form SF3104
Who issues SF 3104?
The form is printed as an Office of Personnel Management form, Revised May 2013, OMB number 3206-0172. GSA hosts a copy in its forms library.
Where do I send SF 3104?
If the deceased was an employee at the time of death, to the personnel office of the agency where the deceased was last employed. If the deceased was a former employee or annuitant, to OPM, FERS, P.O. Box 45, Boyers, PA 16017-0045.
What is SF 3104A?
The Survivor Supplement included in the PDF. The form says to complete it if the deceased was retired at the time of death, and that it is for a surviving spouse under age 60 when the deceased had at least 5 years of creditable civilian service.
When is SF 3104B needed?
The form says that if the deceased was an employee at the time of death and you are the surviving spouse or former spouse, you and the deceased person's agency complete SF 3104B, which the former employing agency provides.
What if I don't know an answer?
The instructions say to write "unknown". If you are unsure, for example of an exact date, answer to the best of your ability followed by a question mark.
Can both parents apply on one form?
No. The form says each parent should complete a separate application, and that if one parent is deceased, a copy of that death certificate is attached.
How long does SF 3104 take?
OPM estimates an average of 60 minutes per response, including the time for reviewing instructions, getting the needed data and reviewing the completed form.