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 **U.S. Railroad Retirement Board**
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 Form G-273a, Funeral Director's Statement Of Burial Charges
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          Lump-Sum Death Payment, Residual Lump-Sum, Annuities Unpaid at Death
          Other Forms You May Need
          Form G-273a, Funeral Director's Statement Of Burial Charges
 Topics
    

      
              Lump-Sum Death Payment
          Residual Lump-Sum
          Annuities Unpaid At Death
          Railroad Tax Refund
          Furnishing Proof to Support Your Application
          After You Apply For Your Benefits
          Other Forms You May Need
                                Form G-273a, Funeral Director's Statement Of Burial Charges
          Form G-126, Election To Receive A Residual a Payment Instead Of Future Monthly Insurance Benefits Based On Service Under The Railroad Retirement Act
          Form G-131, Authorization of Payment and Release of all Claims to a Death Benefit or Accrued Annuity Payment
          Paperwork Reduction & Privacy Act Notice
          Nondiscrimination On The Basis Of Disability
          Fraud, Waste, and Abuse Hotline Form G-273a, Funeral Director's Statement Of Burial Charges
							 
							
							
            RB-21
      
            (12-18)
      
            If you are applying for the lump-sum death payment as the representative from a funeral home, or if there are unpaid funeral home expenses and you are applying to authorize the RRB to pay the funeral home, you must submit a Form G-273a. The Form G-273a must be completed and signed by the funeral home director. If more than one funeral home was involved in the employee's burial, and each funeral home is keeping a separate bill, a Form G-273a must be secured from each funeral home.

The Form G-273a can be used in any lump-sum death payment or unpaid employee annuity case instead of other proof of payment of burial expenses. However, it is required when there are unpaid funeral home expenses.
        ‹ Other Forms You May Need | 
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                      Form G-126, Election To Receive A Residual a Payment Instead Of Future Monthly Insurance Benefits Based On Service Under The Railroad Retirement Act  ›To view and download PDF documents, you need the free Acrobat Reader. We recommend using the latest version. Viewers with visual disabilities can go to Adobe's Access Website for tools and information that will help make PDF files accessible.Get Adobe Acrobat Reader
To view and download PDF documents, you need the free Acrobat Reader. We recommend using the latest version. Viewers with visual disabilities can go to Adobe's Access Website for tools and information that will help make PDF files accessible.
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U.S. Railroad Retirement BoardWilliam O. Lipinski Federal Building844 North Rush Street
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 Last updated: 12/13/2018