Note: If the block is not checked, or is checked “no,” information cannot be released without the written consent of the affected individual.
If an application for benefits from the U.S. or the foreign country has been filed,
information needed by the foreign country pertaining to any individual listed on that
application for whom benefits are being claimed may be disclosed. Consent statement(s)
from the listed individuals is (are) not required.
SSA may disclose information from the application itself, as well as information from
any of the approved systems of records not only under the SSN on which the totalization
claim was filed, but also under any related SSN.
The routine use provision permits, but does not require, disclosure. If an applicant
refuses to authorize disclosure, the application itself may be sent to a foreign agency,
but no information from SSA's record may be released.
If an applicant revokes the authorization contained on the application and specifically
requests that SSA not disclose anything to the foreign agency, the request is treated
as a withdrawal (See GN 01701.135). If the application has already been sent to the foreign agency, the request for
withdrawal should be forwarded to the foreign agency.