BASIC (01-94)

GN 01722.235 Facts About the Spanish Liaison Form E/USA 3

A. When to use form E/USA 3

The Spanish agencies use the liaison form to:

  • transmit material to OIO,

  • send information to OIO, and

  • request information from OIO.

B. Description of the E/USA 3

  • The liaison form is a three page bilingual form.

  • Parts 1 and 2 contain information about the worker and claimants. There are no verification blocks shown in item 2 because all dates have been verified by the Spanish agency.

  • Part 3 provides information about material that the Spanish agency is transmitting with the liaison form.

  • Part 4 lists the information that the Spanish agency is requesting from SSA. This section includes a Privacy Act Authorization to release information to Spain.

  • Part 5 provides general information. By checking the applicable block in this section, the Spanish agency notifies OIO that form USA/E2 has been completed and forwarded to the FSP, Madrid.

C. Exhibit-E/USA 3




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GN 01722.235 - Facts About the Spanish Liaison Form E/USA 3 - 04/02/2014
Batch run: 04/02/2014