This version of the form is not currently in use and is provided for reference only. Download this version of Form SSA-10-INST for the current year.
Form SSA-10-INST, Reporting Responsibilities for Widow's or Widower's Insurance Benefits , is a form used to inform the recipient of widow's or widower's insurance benefits about the reporting responsibilities. The document provides a list of changes you must report and the means to report them.
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The form was issued by the U.S. Social Security Administration (SSA) on April 1, 2017 , with all prior editions are obsolete. A fillable Form SSA-10-INST is available for download and digital filing below. The form - along with Form SSA-10, Application for Widow's or Widower's Insurance Benefits - is used to apply for the Social Security widow's or widower's insurance benefits.
Form SSA-10-INST contains detailed information on the cases you need to report to the SSA. If you do not report these changes on time, you may be forced to repay the overpayments. You also may be subjected to monetary penalties. Report the following changes to the SSA:
If you are under the full retirement age, you also need to report your earnings every taxable year, in which you earn more than the exempt amount within 3 months and 15 days after the end of the year. If you do not report these changes, your benefits will be adjusted based on the earnings reported by your employer and your self-employment tax return. Below are several ways to report the above-listed changes:
The SSA recommends you copy all the documents you submit to the agency and keep these copies for future references.