Central States Pension Fund

Survivor Benefits

Application

Go to Survivor Benefits

When there is a loss

Download the form

To receive Survivor Benefits, fill out the application and either print and mail it back, or upload the form and all related documents using our secure Message Center.


Everything you need to get started is included in the application, and you must fully complete each section to avoid a delay. It is very important that you provide us with timely notice of the member's death along with the completed Survivor Benefits application. Any retroactive benefit payments that you would otherwise be eligible to receive are limited to the 12-month period prior to the date the Fund receives written notification.


Download Application

1 Survivor Benefits Application

You must attach/include copies (not originals) of all appropriate documents including:


  • Copy of the member’s death certificate
  • Copy of your birth certificate
  • Copy of your marriage certificate

Be sure to sign and date the application to avoid any delay with your benefit.

2 Send Us the Form

Be sure to return the entire completed application.

message

Message Center:

The fastest way to send in your application is through the secure Message Center. Registered users can log in to upload forms and attach all required documentation. If your form requires a signature, you must print, sign, and then upload the signed page.
Send us a Secure Message
mail

Mail:

Central States, Southeast and Southwest Areas Pension Fund

P.O. Box 5109

Des Plaines, IL 60017-5109

fax

Fax:

1-847-518-9752

Still need help?

Contact one of our Benefits Specialists for more information on Survivor Benefits.

Contact Us