Forms.gov - The U.S. Government's Official Hub for Federal Forms

Forms Search:
Certificate of Coverage Request
The United States (U.S.) has Social Security agreements with 18 countries. These agreements eliminate double Social Security coverage and taxation where a period of work would be subject to coverage and taxes in both countries. The individual agreements contain rules for determining the country under who laws the period of work will be covered and to whose system taxes will be paid. The agreements further provide that upon the request of the worker or employer, the country under whose system the period of work is covered will issue a certificate of coverage. The certificate serves as proof of exemption from coverage and taxation under the system of the other country. The information collected is needed to determine if a period of work is covered by the U.S. system under an agreement and to issue a certificate of coverage. The respondents are workers and employers wishing to establish an exemption from foreign Social Security taxes.
Form #:  SSA i0554
Agency:  Social Security Administration
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
NEEDED
html Both Form and Instructions 0 0 [3] Fillable + Printable Internet Explorer  

Still Cannot Find a Specific Form Here?

 If you do not find the form you need in the E-Forms Catalog we suggest:

Search through the Agency Forms links.

Search USA.gov, a connection to the U.S. Government's information and services.

Search GSA (GS), Standard (SF) and Optional (OF) Forms, the General Services Administration's library for GSA internal forms and government-wide Standard and Optional Forms.