Basic (02-02)

GN 01740.235 Facts About the Chilean Liaison Form CHI/USA 3

A. Background

The Chilean agencies use Form CHI/USA 3 to:

  • Transmit material to DIO or to the FSP in Buenos Aires, Argentina

  • Send information to DIO or to the FSP, and

  • Request information from DIO.

B. Description of form CHI/USA 3

The Form CHI/USA 3 has the same format and entries as the SSA-2960-CHI. Following are the two main differences:

  • The address blocks in the “TO” and “FROM” sections are reversed, and

  • The item for status of the U.S. claim is not shown.

C. Procedure

If a Chilean liaison agency requests information, make sure that the requirements of the Privacy Act are met. Return any request (without the requested information) unless:

  • The request indicates that the information is needed to process a claim under the agreement,

  • The agency has provided the claimant's written consent for SSA to disclose information, or

  • The file contains a Form SSA-2490-BK that is signed by the claimant.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201740235
GN 01740.235 - Facts About the Chilean Liaison Form CHI/USA 3 - 01/18/2017
Batch run: 01/18/2017
Rev:01/18/2017