A Social Security payment due a deceased beneficiary may be paid to a family member or a legal representative of the estate in the following order. The death benefit is granted to the primary beneficiaries of the deceased member.Name of Deceased had permanent legal residence at. Affidavit of Death Benefit Claim - Free download as Word Doc (. All information contained in the 2022-23 Catalog is current as of March 2022. If the court issued an opinion in a nonreported case, that fact is indicated; otherwise no opinion was written. We also ask that You embrace in Your care Betty Graham and her family in the death yesterday of Betty's sister, Patricia Duggan. Deceased member and that the surviving spouse must not be the one who gave ground for the separation; or b. Affidavit of surviving spouse with undertaking. Notarized Sworn Statement (Sinumpaang Salaysay) from the dependent, attesting the details of the member's death.