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NATIONAL SOCIAL SECURITY AGREEMENT If the worker is living, this application should be completed by or on behalf of the worker. If the worker is deceased, this application should be completed by one of the worker's survivors who is claiming benefits under the provisions of the international social security agreement. PART 1 Complete Part 1 in all cases. 1. (a) Print name of worker (First name, middle initial, last name) (b) U.S. Social Security Number 2. Provide the following information about.

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How to fill out the SSA-2490-BK online

The SSA-2490-BK is a crucial form used for applying for benefits under a U.S. international social security agreement. This guide provides a clear, step-by-step approach to assist users in completing the form online effectively.

Follow the steps to fill out the SSA-2490-BK with ease.

  1. Click ‘Get Form’ button to obtain the SSA-2490-BK and open it in the editing platform.
  2. Begin with Part 1 by entering the worker's name and U.S. Social Security number in the designated fields.
  3. Provide information regarding the worker's social security credits and last residence in the foreign country using the specified columns for employment or self-employment history.
  4. Enter details about the worker's periods of coverage under the foreign social insurance system if applicable.
  5. Specify the worker's last place of residence in the foreign country.
  6. Indicate the type of benefits claimed from both the United States and the foreign country by checking the appropriate boxes.
  7. Fill in information about the worker, including any alternative names and Social Security numbers in different countries.
  8. Proceed with any additional inquiries that may apply regarding refugee status, military service, and employment history.
  9. Complete the section for dependents if any, detailing information about children or spouses eligible for benefits.
  10. Review all responses for accuracy before finalizing the form; then proceed to save, download, print, or share the completed application.

Complete your SSA-2490-BK form online to ensure a smooth application process.

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OK TDF 2 2012 OR 250-14 2010 OR 735-11 2010 OR 735-165 2002

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