Certificate of Coverage Request via Internet - Individuals in Denmark, Netherlands, Norway, & Sweden

International Programs - International Agreements

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Social Security
The Official Website of the U.S. Social Security Administration

International Programs
International Programs home / International Agreements

International Agreements
General Overview

More Information

How the bilateral agreements program helps people who work in the U.S. and
After browsing our Web site, if you

abroad.

have questions about international

Description And Text Of Each Agreement

Social Security agreements, call
the Social Security

Look here for links to online versions of our pamphlets describing each of the 24

Administration's Office of

U.S. agreements, as well as the complete text of each agreement.

International Programs. Call (410)
965-3322 if you have questions on

Certificates Of Coverage

benefits under the agreements.

Employers should look here to learn how to request the documentation needed to
avoid Social Security taxes in a foreign country under an agreement.

For questions on the coverage
rules of the agreements, call (410)
965-7306. However, please do not

Information For Employees Of Foreign Governments

call these numbers if you wish to
inquire about an individual benefit

Employees of foreign Goverments should look here to understand their coverage

claim. For inquiries about an

by Social Security.

individual benefit claim, contact
the Office of International

Status Table

Operations.

Here you will find a table showing the signing date, effective date and legal citation
for all agreements in force and the status of pending agreements.

Last reviewed or modified 07/25/2012

http://www.ssa.gov/international/totalization_agreements.html

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International Programs - Online Certificate of Coverage Service

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Social Security
The Official Website of the U.S. Social Security Administration

International Programs
International Programs home / Online Certificate of Coverage Service

Online Certificate of Coverage Service
Introduction
Are you a U.S. employer with operations in other foreign countries? Do you send
employees to work temporarily overseas? If so, you and your employees may
benefit from the bilateral Social Security agreements the United States has
concluded with certain foreign countries.
These agreements, often called "Totalization" agreements, eliminate dual Social
Security taxation, the situation that occurs when an employee from one country
works in another country and is required to pay Social Security taxes to both to
both countries on the same earnings. The agreements assign coverage to just one
country and exempt the employer and employee from the payment of Social
Security taxes in the other country.

What Are Certificates Of Coverage?
If a Social Security agreement assigns coverage of the employee's work to the
United States, the Social Security Administration issues a U.S. Certificate of
Coverage. The certificate serves as proof that the employee and employer are
exempt from the payment of Social Security taxes to the foreign country.
U.S. employers have traditionally used regular mail and fax to request certificates
of coverage for their expatriate employees. Now, you can request certificates on
line.

Confidentiality
The Social Security Administration has taken reasonable measures, including
encryption, to ensure we do not disclose your personal information to a third
party. The Web is an open system and we cannot guarantee that others will not
intercept and decrypt the information you send. To request a Certificate of
Coverage by mail or fax, please take a look at the descriptions of individual Social
Security agreements.

http://www.ssa.gov/international/CoC_link.html

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International Programs - Online Certificate of Coverage Service

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What Are The Advantages Of The Online Service?
• Faster service — eliminates the need for data rekeying,
• Data verification — checks data for keying errors or missing information
before transmission,
• Email confirmation — provides an option to request confirmation of
approved Certificate requests,
• Online help — provides help for completing data fields, and
• Up to date information — Online form is always the latest edition.

Accessing The Online Certificate Request Forms
You may access the online Certificate of Coverage service at
www.socialsecurity.gov/coc. If you would like instructions or require assistance
with the use of the online forms, please contact the Social Security Administration's
Office of International Programs by phone at
(410) 965-7306, Monday through Friday, from 8 a.m. to 3 p.m. Eastern U.S. time.

Last reviewed or modified 07/16/2012

http://www.ssa.gov/international/CoC_link.html

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ONLINE CERTIFICATE OF COVERAGE SERVICE--INTRODUCTION

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Go To Online Request Forms
Welcome to SSA's Online Certificate of Coverage Service. Employers who use this service can expect to receive
Certificates several weeks faster than by mail. The online system eliminates delays due to data rekeying and provides
automated error checking, resulting in fewer rejected applications.
This is one of several online processes SSA is making available as part of our efforts to provide World Class Service to
the public. Let us have your FEEDBACK on this service (but please do NOT send confidential information, such as a
Social Security number, through our Feedback form).

WHAT ARE CERTIFICATES OF COVERAGE?
z

z

z

SSA issues Certificates of Coverage pursuant to bilateral Social Security agreements with foreign
countries. These agreements are sometimes called "Totalization" agreements. They eliminate dual Social
Security coverage, the situation that occurs when an employee from one country works in another country and
is required--together with the employer--to pay Social Security taxes to both countries on the same earnings. A
Totalization agreement assigns coverage to just one country and exempts the employer and employee from
Social Security taxes in the other country.
If an agreement assigns coverage of an employee's work to the United States, a Certificate of U.S. Coverage
issued by SSA serves as proof that the employee and employer are exempt from Social Security taxes in the
other country.
You can request Certificates of Coverage under Totalization agreements with the following 24 countries:
Australia, Austria, Belgium, Canada, Chile, Czech Republic, Denmark, Finland, France, Germany, Greece,
Ireland, Italy, Japan, Korea (South), Luxembourg, the Netherlands, Norway, Poland, Portugal, Spain, Sweden,
Switzerland, and the United Kingdom.

WHO SHOULD USE THE ONLINE CERTIFICATE REQUEST FORMS
If you are a U.S. employer sending an employee to work in an agreement country for 5 years or less, you can use the
online form corresponding to that agreement to request a Certificate of U.S. Coverage. If you have an employee
working in Italy, under certain conditions you can use the online form for that country even if the employee will be
working there for more than 5 years.

CONFIDENTIALITY
SSA is taking all reasonable and appropriate measures, including encryption, to ensure that personal information you
send us using the online forms is not disclosed to any third party. However, the Internet is an open system and we
cannot absolutely guarantee that the information you are sending will not be intercepted by others and
decrypted. Although this possibility is remote, it does exist.
If you are not comfortable with these risks, please see one of our articles on individual Totalization agreements to
learn how to request a Certificate of Coverage by mail or fax.

https://secure.ssa.gov/apps6z/coc_db/allforms.html

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ONLINE CERTIFICATE OF COVERAGE SERVICE--INTRODUCTION

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WHERE WE WILL MAIL THE CERTIFICATE
If the employee qualifies for a Certificate, we will mail the Certificate to the U.S. address you furnish in the section of
the form entitled YOUR U.S. LOCATION. If you would like the Certificate mailed to a different U.S. address, also
complete the section entitled MAILING ADDRESS at the end of the form.

EMPLOYEES OF FOREIGN AFFILIATES
If you are a U.S. employer, and you are sending an employee to work for a foreign affiliate of your company (rather
than directly for you), please read this IMPORTANT NOTE.

HOW TO FILL OUT THE FORM
z

z

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Please complete the form as completely and accurately as possible or the processing of your request could be
delayed. Most of the information requested is required under the terms of the Totalization agreements, and
you will not be able to transmit your request to our server unless these required data fields are completed.
Each data field is limited to a maximum number of characters. On most forms, we have designated the field's
maximum size in parentheses. Please DO NOT exceed this size or your entry will be truncated.
Online Help is available for filling out each item on the forms. Just click on the "hypertext" heading.

PERFORMER CERTIFICATE
Most countries do not try to collect social security contributions for workers who are in their territory for very short
stays. Some agreement countries, however, require performers who work in their country to obtain a U.S. certificate
of coverage to prove their exemption from foreign Social Security taxes, regardless of the length of time the individual
will be in their country.
Because of the large number of requests involved, simplified procedures involving the issuance of abbreviated ("shortform") certificates for performers have been adopted under some of our agreements.
For purposes of the "short-form" certificate procedure, the term "performers" includes: musicians, dancers, actors,
and support personnel who travel with the performers (e.g., managers and equipment handlers).
If you want to submit a performer certificate, please click Online Performer Certificate
HOW TO REACH US
If you have any questions or comments, you can reach us
z
z

by e-mail at: [email protected]
by writing to:
SOCIAL SECURITY ADMINISTRATION
Office of International Programs
P.O. Box 17741
Baltimore, MD 21235-7741
USA

z

by telephone at (410) 965-7306 or by FAX at (410) 966-1861.

PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS

https://secure.ssa.gov/apps6z/coc_db/allforms.html

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The Privacy Act requires us to notify you that we are authorized to collect this information by section 233 of the Social
Security Act. While it is not mandatory for you to furnish the information to the Social Security Administration (SSA), a
certificate of coverage cannot be issued unless a request has been received. The information is needed to enable SSA to
determine if current work should be covered only under the U.S. Social Security system in accordance with a Totalization
agreement. Without the certificate, current work may continue to be subject to coverage and taxation under both the U.S. and
the foreign Social Security systems.
This information collection meets the clearance requirements of 44 U.S.C. §3507, as amended by section 2 of the Paperwork
Reduction Act of 1995. You are not required to answer these questions unless we display a valid Office of Management and
44 minutes to read the instructions, gather the necessary
Budget control number. We estimate that it will take you about 30
facts, and answer the questions.

ONLINE REQUEST FORMS
After reading the above, if you are ready, we invite you to request a Certificate of Coverage for any of the countries
listed below:
k | Finland | France
Australia | Austria | Belgium | Canada | Chile | Czech Republic | Denmark
Germany | Greece | Ireland | Italy | Japan | Korea (South) | Luxembourg | Netherlands
Norway | Poland | Portugal | Spain | Sweden | Switzerland | United Kingdom

Future Revised Editions
SSA forms are subject to periodic revisions. You can be assured that this SSA Internet Server Page will always have the
latest edition. Please check this Page to make certain that you have the latest edition.

Revision Date: September 1st, 2005
SSA Online Home | International Page | Privacy Policy
| Search | Feedback (please, no confidential information)

https://secure.ssa.gov/apps6z/coc_db/allforms.html

6/5/2013

CERTIFICATE OF COVERAGE REQUEST FORM--DENMARK

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Certificate of Coverage Request Form-U.S.-DANISH SOCIAL SECURITY AGREEMENT

If you are a U.S. employer sending an employee to work in Denmark for 5 years or less, you can use this form to request a Certificate of
U.S. Coverage under the Social Security agreement between the United States and Denmark. Before completing the form, however,
PLEASE READ THE IMPORTANT INTRODUCTORY MESSAGE if you have not already done so.
If you would like more information about the U.S.-Danish agreement, visit the home page of SSA's Office of International Programs.
For online help completing any of the following fields, click on the number immediately preceding the field.

INFORMATION ABOUT THE EMPLOYEE
1) First Name

Middle Initial

2) Last Name
3) U.S. Social Security Number
4) Danish Social Security Number (if known)
5) Date of Birth: Month

Day

Year

6) Country of Birth
7) Country of Citizenship
8) Country of Permanent Residence
9) Date of Hire: Month

Day

Year

10) Country of Hire

https://secure.ssa.gov/apps6z/coc_db/country_form.jsp?ctr_code=DK&ctr=Denmark&czn=Danish&tp=5

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11) Beginning date of assignment in Denmark:
Month

Day

Year

12) Expected ending date of assignment in Denmark:
Month

Day

Year

13) Information about employee's family members (include only if accompanying the employee to the Denmark):
Spouse:
First Name

Last Name

Danish Social Security Number (if known):
Date of Birth: Month

Day

Year

Children (if more space is needed, include in the comment box at the end of this form):
First Name

Last Name

Danish Social Security Number (if known):
Date of Birth: Month

First Name

Day

Year

Last Name

Danish Social Security Number (if known):
Date of Birth: Month

First Name

Day

Year

Last Name

Danish Social Security Number (if known):
Date of Birth: Month

First Name

Day

Year

Last Name

Danish Social Security Number (if known):
Date of Birth: Month

Day

Year

https://secure.ssa.gov/apps6z/coc_db/country_form.jsp?ctr_code=DK&ctr=Denmark&czn=Danish&tp=5

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INFORMATION ABOUT THE EMPLOYER
AMERICAN EMPLOYER OR FOREIGN AFFILIATE?
14) Please select one of the options below:
We are a U.S. employer for whom the employee named above will be working directly (for example, in a branch office) while in
Denmark.
The employee named above will be working for a foreign affiliate of our company, and the affiliate is covered by a section 3121(l)
agreement. The date on which the section 3121(l) agreement became effective for this affiliate is:
Month

Day

Year

.

YOUR U.S. LOCATION
15) Company Name used in the U.S. (Start with Block 1 and use Block 2 if necessary):
Block 1
Block 2
16) U.S. Street Address (Start with Block 1 and use Block 2 if necessary):
Block 1
Block 2
17) City
18) State
19) ZIP

-

YOUR LOCATION IN DENMARK
20) Company Name in Denmark (Start with Block 1 and use Block 2 if necessary):
Block 1
Block 2
21) Street Address in Denmark (Start with Block 1 and use Block 2 if necessary):
Block 1
Block 2
22) City
23) Postal Code

https://secure.ssa.gov/apps6z/coc_db/country_form.jsp?ctr_code=DK&ctr=Denmark&czn=Danish&tp=5

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INFORMATION ABOUT THE CONTACT PERSON
24) Your Name
25) Your Title
26) Your Telephone Number (

)

-

27) Extension (if any)
28) Your E-Mail Address (required if you wish to be notified by e-mail when your request is approved)

MAILING ADDRESS
If you would like the Certificate or other correspondence mailed to a U.S. address other than the employer address you provided
in the section entitled "YOUR U.S. LOCATION", please complete blocks 27 thru 32. Otherwise, we will use the address provided
in the YOUR U.S. LOCATION section.
29) Name of Person to Receive Correspondence
30) Company Name (Start with Block 1 and use Block 2 if necessary):
Block 1
Block 2
31) Street Address (Start with Block 1 and use Block 2 if necessary):
Block 1
Block 2
32) City
33) State
34) ZIP

-

Is there anything else we need to know?
(Comments are limited to 960 characters - about 16 lines of text)

https://secure.ssa.gov/apps6z/coc_db/country_form.jsp?ctr_code=DK&ctr=Denmark&czn=Danish&tp=5

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CERTIFICATE OF COVERAGE REQUEST FORM--DENMARK

SEND Form

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CLEAR All Fields

Please do not fill the field below, it is for displaying submit status
Status: not submitted.

Future Revised Editions
SSA forms are subject to periodic revisions. You can be assured that this SSA Internet Server Page will always have the latest edition.
Please check this Page to make certain that you have the latest edition.
Revision Date: Setember 1, 2008

Privacy and Paperwork Reduction Act Statements
Top of Page
SSA Online Home Page
International Page
Search Our Web Site
Feedback (please, no confidential information)

https://secure.ssa.gov/apps6z/coc_db/country_form.jsp?ctr_code=DK&ctr=Denmark&czn=Danish&tp=5

6/6/2013

ONLINE CERTIFICATE OF COVERAGE SERVICE--INTRODUCTION

Page 1 of 1

PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS
The Privacy Act requires us to notify you that we are authorized to collect this information by section 233 of the Social
Security Act. While it is not mandatory for you to furnish the information to the Social Security Administration (SSA), a
certificate of coverage cannot be issued unless a request has been received. The information is needed to enable SSA to
determine if current work should be covered only under the U.S. Social Security system in accordance with a Totalization
agreement. Without the certificate, current work may continue to be subject to coverage and taxation under both the U.S. and
the foreign Social Security systems.
This information collection meets the clearance requirements of 44 U.S.C. §3507, as amended by section 2 of the Paperwork
Reduction Act of 1995. You are not required to answer these questions unless we display a valid Office of Management and
44 minutes to read the instructions, gather the necessary
Budget control number. We estimate that it will take you about 30
facts, and answer the questions.

https://secure.ssa.gov/apps6z/coc_db/allforms.html

6/5/2013