The SSA-2490-BK is available through MCS, but the MCS version may only be used when
the NH is filing for
U.S. retirement or disability Totalization benefits alone, or
U.S. retirement or disability benefits (regular or Totalization) and concurrently
for Dutch benefits.
The MCS version of the SSA-2490 may not be used to file for
U.S. or Dutch survivors benefits.
A paper SSA-2490-BK application form must be used in the latter cases.
NOTE: It is not necessary to take an SSA-2490-BK in claims for U.S. auxiliary benefits in
life cases or in survivor cases where there was a previously approved award in a life
case since this application would have been completed previously in connection with
the NH's claim.