An applicant for Italian benefits must complete one or more special Italian application forms, in addition to Form SSA-2490-BK (Application for Benefits under a U.S. International Social Security Agreement). The forms will vary depending on the type of benefit.

The Social Security Administration (SSA) Field Offices (FO) will not provide the applicant with any special Italian application forms. After receiving an Italian benefits claim filed with SSA, the Italian agency will contact the applicant directly, if necessary, and provide instructions for the applicant to complete and mail any special Italian forms directly to the Italian agency along with any additional required evidence.

If an applicant wishes to file for Italian benefits and brings the special forms for Italian benefits to the FO, take the following actions:

1. 1. 

   Accept, photocopy, and certify the application; and

2. 2. 

   Photocopy and certify any additional documents (evidence) the Italian agency requested that the applicant included with the Italian claim; and

3. 3. 

   Request an “Informational/Certified Earnings Record” (ICERS) as described in MS 02101.004 Informational/Certified Earnings Records - Totalization (ICIC); and

4. 4. 

   Send the Italian application and any additional claims material to the Division of International Operations (DIO) in Baltimore MD. at the following address:

Social Security Administration
OEIO - DIO
P.O. Box 17769
Baltimore, MD 21235-7769
USA

5. Complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the Italian claim to DIO, and show, “Totalization” as the ISSUE.

Once DIO receives the claim, they will send the claim directly to the Italian agency along with the evidence and the worker’s U.S. coverage record. DIO will annotate the MDW to show the type of claim, and the date they forwarded the claim to the Italian agency.

If an applicant wishes to file a claim for Italian benefits, see GN 01705.215 for instructions on how to accept the claim.

• •

  GN 01705.215 Applications for Benefits under the U.S. - Italian Agreement.

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  GN 01702.310 Routing of Claims for U.S. Benefits Involving Totalization.

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  MS 02101.004 Informational/Certified Earnings Records - Totalization (ICIC) - Informational/Certified Earnings Records – Totalization (ICIC).