Item a, Last Full Address in Netherlands
Determine the worker's last place of residence in the Netherlands from the remarks
portion of the SSA-2490-BK and enter it in the space provided. (For information on
the evidence required for U.S. Totalization benefits under the Dutch agreement, see
GN 01725.205B.)
Item b, Name and Address of last Dutch employer
In Dutch disability claims, determine the name and address of the worker's last employer
in the Netherlands from the remarks portion of the SSA-2490-BK and enter it in the
space provided. (For information on developing evidence in claims for Dutch benefits,
see GN 01725.210D.)