Get Ssa-2490-bk 2004

The SSA-2490-BK form is an application for benefits under a U.S. international social security agreement. This guide offers step-by-step instructions to help you accurately complete the form online, ensuring a smooth application process.

Follow the steps to fill out the SSA-2490-BK online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Part I, enter the worker's full name and social security number in the designated fields (1a and 1b).
3. Provide information about the worker's social security credits and last place of residence in the foreign country. Use the specified columns to detail periods of employment or self-employment in the foreign country (2a).
4. Continue by detailing periods of coverage under the foreign social insurance system (2b) and entering the worker's last place of residence in the foreign country (2c).
5. In item 3, indicate all benefits for which you are eligible under the agreement by specifying the name of the foreign country.
6. In item 4, check the relevant boxes to indicate the type of benefits being claimed from both the foreign country and the United States.
7. Complete details about the worker in item 5, including name at birth, sex, social insurance number in the foreign country, and parents' names if necessary.
8. Item 6 requires checking if you want to protect an eligible spouse's and/or child's right to benefits.
9. If applicable, complete items 7 through 10 regarding the worker's military service, disability status, and additional information about claims.
10. Fill out information about the applicant in item 11 if you are not the worker, followed by details about the worker in items 12 to 19.
11. Finally, review all entries for accuracy, and after signing the application, save any changes made and download or print the form for submission.

Complete your SSA-2490-BK form online today for timely processing of your benefits.