U.S. Office of Personnel Management (OPM) Edition Standard Form 3104, Revised May 2013 (OMB 3206-0172), with SF 3104A Survivor Supplement 8 pages

SF 3104 — Application for Death Benefits, Federal Employees Retirement System

Claim the survivor benefits payable under FERS after a federal employee's, former employee's or retiree's death.

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SF 3104 · Application for Death Benefits - Federal Employees Retirement System
The official U.S. Office of Personnel Management (OPM) form, edition Standard Form 3104, Revised May 2013 (OMB 3206-0172), with SF 3104A Survivor Supplement — blank
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Fill this form online Blank PDF from U.S. Office of Personnel Management (OPM)

What is SF 3104?

Standard Form 3104 is the application for benefits payable under the Federal Employees Retirement System (FERS) because of the death of an employee, former employee or retiree covered by FERS. The widow(er), a former spouse, a designated beneficiary, children or their guardian, a parent or the court-appointed executor use it to claim a survivor annuity, the Basic Employee Death Benefit or a lump-sum payment.

It covers the deceased, you, the spouse or former spouse, dependent children, other heirs, the estate, active military service, payment instructions and a checklist of documents. The PDF also includes SF 3104A, the Survivor Supplement, for a surviving spouse under 60 of a retiree. The current edition is Revised May 2013 (OMB 3206-0172). For a death under the Civil Service Retirement System, use SF 2800 instead.

FileIt pre-fills your name and date of birth, shows only the sections that apply to you, repeats the details SF 3104A needs, and fills OPM's own PDF. It checks dates and that every answer fits its box, and saves the finished form in your vault folder. The application must be signed in ink, so you print it, sign it and send it yourself.

Who files
Survivors of a FERS employee, former employee or retiree: widow(er), former spouse, designated beneficiary, child or guardian, parent, or the estate's executor.
Send it to
If the deceased was an employee: the personnel office of the agency where they last worked. If a former employee or annuitant: OPM, FERS, P.O. Box 45, Boyers, PA 16017-0045.
Always attach
A certified copy of the death certificate.
Also in the PDF
SF 3104A, Survivor Supplement, for a surviving spouse under 60 of a deceased retiree.
Signed
In ink by the applicant named in Section B.
Edition
Standard Form 3104, Revised May 2013 (OMB 3206-0172)

Who needs to fill out SF 3104?

  • The widow or widower of a federal employee or retiree covered by FERS.
  • A former spouse with a court order awarding a share of the FERS survivor annuity or Basic Employee Death Benefit.
  • A designated beneficiary, a child or guardian, a parent, or the executor of the estate claiming a lump sum.
  • A surviving spouse under 60 of a FERS retiree who may qualify for the survivor supplement.

When to use SF 3104

  • After the death of a federal employee, former employee or retiree covered by FERS.
  • Together with SF 3104B from the employing agency, when the deceased was an employee at the time of death and you are the spouse or former spouse.
  • With SF 3104A completed, when the deceased was retired and you are the surviving spouse under age 60.

What you need before you start

  • The deceased's full name, date of birth, date of death, Social Security number and CSA number if retired.
  • Details of the deceased's spouse and former marriages, with copies of the death certificates or divorce decrees that ended them.
  • Your name, date of birth, Social Security number and citizenship.
  • Your marriage certificate (widow(er)) or divorce decree and court order (former spouse).
  • Each dependent child's name, date of birth, relationship and SSN, with birth certificates and any Social Security award or denial notices.
  • Your bank's routing number and account number, or a Direct Express card.

What’s on SF 3104

The 2013 edition has 8 pages. FileIt asks for it in 12 parts:

  1. Section A - Information about the deceasedApplicant (survivor or estate)
  2. Section B - Information about the applicantApplicant (survivor or estate)
  3. Section C - The spouse of the deceasedApplicant (survivor or estate)
  4. Section D - The former spouse of the deceasedApplicant (survivor or estate)
  5. Section E - The deceased's dependent childrenApplicant (survivor or estate)
  6. Section F - Other heirsApplicant (survivor or estate)
  7. Section G - The estate of the deceasedApplicant (survivor or estate)
  8. Section H - Active military serviceApplicant (survivor or estate)
  9. Section I - Payment instructionsApplicant (survivor or estate)
  10. Section J - CertificationApplicant (survivor or estate)
  11. Section K - Applicant's checklistApplicant (survivor or estate)
  12. SF 3104A - Survivor SupplementApplicant (survivor or estate)

How to fill out SF 3104, step by step

1 Section A - The deceased

Name, dates of birth and death, SSN, other names, CSA number, any OWCP workers' compensation claim, employment status at death (employee, former employee or retiree), the spouse at death and every former marriage.

2 Section B - You

Your name, date of birth, SSN and citizenship, every capacity you apply in, and whether you cashed any check or withdrew any direct deposit paid to the deceased after the death.

3 Sections C and D - Spouse or former spouse

A widow(er) gives the marriage details, remarriage and any other survivor annuity applied for. A former spouse gives the marriage and divorce dates, any court order, FEHB premiums, remarriage and other survivor annuities.

4 Section E - Dependent children

Unmarried dependent children in order of birth, who has responsibility for them, and whether Social Security benefits have been applied for, since FERS children's benefits wait for SSA's decision.

5 Sections F to H - Heirs, estate and military service

Other relatives who can inherit, whether a court has appointed an executor, and (for spouses and former spouses) the deceased's active military service and military retired pay.

6 Sections I to K and SF 3104A

Direct deposit or Direct Express, your mailing address and phone, your signature and the document checklist; then, if it applies, the Survivor Supplement questions about disability and Social Security mother or father benefits.

Common mistakes to avoid

  • Leaving out former marriages: write "none" if there were none, and attach the documents that ended any that existed.
  • Forgetting the certified copy of the death certificate, which is required in all cases.
  • Applying as executor on the strength of a will: OPM pays only a court-appointed executor or administrator.
  • Not applying to Social Security for the deceased's minor or disabled children, which delays their FERS benefits.
  • Skipping SF 3104A when you are a surviving spouse under 60 of a retiree.

After you fill it out

Print the form, sign SF 3104 (and SF 3104A if you completed it) in ink, and attach the documents in the Section K checklist.

Send it to the deceased's employing agency (if an employee at death) or to OPM, FERS, P.O. Box 45, Boyers, PA 16017-0045.

If your address changes before you get a claim number, write to OPM with your and the deceased's names, dates of birth and Social Security numbers.

Keep a copy. FileIt saves the PDF in your vault folder.

Fill out SF 3104 online with FileIt

  1. Pick the person. Choose someone from People and FileIt fills in their name, date of birth, address and other details it already knows.
  2. Answer plain-language questions. One part of the form at a time, with the official help text beside each question — 171 fields in all. Your answers save as you go.
  3. Check the live preview. Watch your answers land on the real U.S. Office of Personnel Management (OPM) form, and let FileIt do any worksheet arithmetic.
  4. Generate the official PDF. FileIt prints your answers into the agency’s own PDF and files it in that person’s folder in your vault.

FileIt fills the form — it never files or submits anything for you. Deliver the finished form to whoever asked for it, the way the form’s instructions say.

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SF 3104: frequently asked questions

What's the difference between SF 3104 and SF 2800?

SF 3104 is for deaths under the Federal Employees Retirement System (FERS); SF 2800 is for the Civil Service Retirement System (CSRS).

What is SF 3104A?

The Survivor Supplement, attached to SF 3104. A surviving spouse under 60 of a FERS retiree who had at least 5 years of creditable civilian service completes it to see if a supplement to the survivor annuity is payable.

Can I sign SF 3104 electronically?

Not with FileIt. The form says to sign in ink and not print your signature.

Can I be paid by debit card?

Yes. Section I lets you choose direct deposit into a checking or savings account, or a Direct Express debit card.

What if I don't know an answer?

The instructions say to write "unknown", and if you're unsure, for example of an exact date, to answer as best you can followed by a question mark.

Official sources

FileIt is not affiliated with or endorsed by U.S. Office of Personnel Management (OPM) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-10-25.

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