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Get SSA-7163 2001

EASE PRINT YOUR ANSWERS NAME OF WORKER ON WHOSE ACCOUNT BENEFITS ARE BEING PAID WORKER'S SOCIAL SECURITY CLAIM NUMBER / NAME OF EMPLOYED OR SELF-EMPLOYED BENEFICIARY / BENEFICIARY'S SOCIAL SECURITY NUMBER (If different from worker's) / / 1. Give the following information about your employment or self-employment outside the United States. NAME AND ADDRESS OF EMPLOYER (IF SELF-EMPLOYED, SHOW "SELF"AND ADDRESS OF YOUR TRADE OR BUSINESS.) Work Period TYPE OF BUSINESS DATE BEGAN (Month, Day,.

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