BASIC (02-94)

GN 01734.235 Facts About the Luxembourg Liaison Form LUX/USA 3

A. List of form lux/USA 3 functions

The Luxembourg agencies use the liaison form to:

  • transmit material to OIO,

  • send information to OIO, and

  • request information from OIO.

B. Description of the LUX/USA 3

Following is a description of the items on the form LUX/USA 3:

  • Parts I and II contain information about the worker and claimants. The “verified” blocks in Part II are checked if the Luxembourg agency has verified the dates for their claim.

Note: Dates are shown in year/mo/day format.

  • Part III provides information about material that the Luxembourg agency is transmitting with the liaison form.

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

  • Part V contains remarks.

C. Exhibit

 

G-LUX-USA-3

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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201734235
GN 01734.235 - Facts About the Luxembourg Liaison Form LUX/USA 3 - 04/18/2014
Batch run: 04/18/2014
Rev:04/18/2014