Bost Community Services generously shared a representative payee estate designation form that they use when a client who has a representative payee passes away without a designated beneficiary for their remaining funds. This type of form documents the client’s wishes regarding disposition of their remaining SSA representative payee funds and personal property.

Providers who would like a copy of this form type are encouraged to:
1. Reach out through the DDPA provider network — contact DDPA directly to be connected with providers who have shared forms of this nature.
2. Consult with legal counsel before adopting any estate-related form, as requirements vary based on the client’s situation, SSA representative payee program rules, and applicable state law.

Note: Representative payees have specific obligations under SSA rules regarding management of funds after a beneficiary’s death — including returning any funds received after the date of death. These obligations apply regardless of whether a designation form is in place. SSA’s Program Operations Manual System (POMS) section on representative payee responsibilities is the authoritative reference.