The special Australian forms are taken in the field offices (FO's). If an applicant
wishes to file for Australian benefits, the FO should:
Access the Totalization Benefits Resource
Print Part A and B of the Australian application form (Form AUS140–US(A).0210) and
income and assets form (Form Mod i) and give them to the applicant for completion.
If the applicant is filing for disability benefits, also print the Work Ability form
(Form WA) and give it to the applicant for completion.
Provide any necessary assistance in completing the Australian forms.
Photocopy and certify any documents (evidence) submitted by the applicant.
Send the claim (with certified copies) to OIO in Baltimore at the address shown in
Once OIO receives the claim, OIO will send the claim directly to the Australian agency
along with a copy of the applicant's U.S. coverage record.
NOTE: Most individuals filing for Australian benefits should be able to complete the Australian
forms without assistance using the instructions provided with the application.