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New Jersey

B-40 Affidavit for Claiming Benefits Due to a Deceased Person

Submit this form if you are the spouse, next of kin, or executor/administrator for a claimant who passed away before receiving benefits he or she was due. The completed form and any supporting documents can be emailed to CollateralClaims@dol.nj.gov [CollateralClaims@dol.nj.gov].

Expiration Date

December 31, 2025

Updated Date

March 6, 2025

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