COMPLETE THESE FORMS IN LEGIBLE BLOCK PRINTING.
The transmittal/request form is the cover sheet of packages prepared for foreign agencies
in Italy and Switzerland. The form is printed in English and the official language(s)
of the country of agreement. As the name suggests, it is a routing form used to transmit
information and documents to foreign agencies. It is also used to request information
from foreign agencies.
It is a snap-out form consisting of at least the original (blue) and a file copy (white).
If the form is used to request information, prepare a Form SSA-382-U2 to control the
Enter identifying information fully and legibly. Never leave the “foreign insurance number” block blank—enter either the number or “Unknown.”
Part II and Part III of the form should be completed, if appropriate. Check the appropriate
boxes and enter names and dates as needed. If the “other” block in Part II and/or Part III is used, be specific and concise. Either request
information using Part III or indicate that no information is being requested.
Part IV of the form is used for “Remarks.” When making an entry in this block, be concise. Do not use jargon.
Sign and date the file copy of Form SSA-2960.