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Survivor Change of Status Forms

The following forms are used in the case of a change of status of a survivor. Please note that there are specific forms for changing the status of a child of a survivor and the spouse of a survivor. There are also separate forms to be used depending on which group the spouse or parent of the survivor was a member. You should complete the appropriate form below and mail, email, or fax it to the DCRB Member Services Center.

If you have further questions, please contact DCRB Member Services at the number below or call the Member Services toll-free number at 1(866) 456-3272.

Service Contact: 
Member Services Center
Contact Email: 
Contact Phone: 
(202) 343-3272
Contact Fax: 
(202) 566-5001
Contact TTY: 
711