`Search the Social Security Death Index`

Surname First Name Middle Initial Social Security # - - Issued by Soundex? Advanced Option#1--Last Known Residence City State/Country County/Province Zip Code Advanced Option#2--Birth & Death Birth Day Month Year Death Day Month Year The SS-5 Form

	Surname
	First Name
	Middle Initial
	Social Security #	- -
	Issued by
	Soundex?

	Advanced Option#1--Last Known Residence
	City
	State/Country
	County/Province
	Zip Code

	Advanced Option#2--Birth & Death
	Birth	Day Month Year
	Death	Day Month Year