TN 5 (04-97)
GN 01707.220 Additional Applications for German Benefits
In addition to the Form SSA-2490-F4, an applicant for German benefits must complete a special German application form. The form(s) to be completed vary depending on the type of benefit claimed. The D/USA 1 is used in life cases to claim retirement or disability benefits. The D/USA 2 is used to claim survivors benefits. The D/USA ZA is used by individuals who wish to claim German benefits (life or death) and who, at the same time, also wish to apply to make special voluntary contributions to Germany under the provisions of the second supplementary agreement (see GN 01707.136).
Note: Germany does not automatically convert life benefits to survivor benefits upon the death of the worker. Therefore, an application for survivor benefits must be filed even when the claimant was receiving life benefits on the record of the deceased worker.
The special application form(s) are not taken in the Field Offices (FO). After receiving a claim for German benefits that was filed with an FO, the German agency with jurisdiction of the claim will mail the appropriate German application to the applicant with instructions to complete the form and mail it directly to Germany along with any necessary additional evidence that may be needed.
If an applicant brings one of the German application forms to the FO:
provide any necessary assistance in completing the form, and
return the application(s) to the applicant and advise him or her to return it directly to the German agency that sent the application form.
Reminder: Do not mail the German application form(s) to OIO.