BASIC (09-02)

GN 01744.235 Facts About the Australian Liaison Form AUS/USA 3

A. When to use form AUS/USA 3

Centrelink uses form AUS/USA 3 to:

  • Transmit material to OIO or VARO

  • Send information to OIO or VARO, and

  • Request information from OIO.

B. Exhibit – Form AUS/USA 3

G-AUS-USA_3-1

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G-AUS-USA_3-2

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C. Description of form AUS/USA 3

1. Part 1

Part 1 contains information about the claimant.

2. Part 2

Part 2 contains information about the worker. All dates provided by Centrelink are verified..

3. Part 3

Part 3 contains information about the spouse or former spouse. All dated provided by Centrelink are verified.

4. Part 4

Part 4 contains information provided by Australia, including the protective filing date (lodgement date).

5. Part 5

Part 5 contains a list of the type of information that Centrelink might request from OIO along with the remark that the information is needed to process a claim under the agreement. Centrelink needs all benefit rates from the date of entitlement but not prior to the beginning date of the agreement, October 1, 2002..

6. Part 6

Part 6 contains remarks.

7. Part 7

Part 7 contains the signature and date.

D. Procedure

In addition to the procedures for handling foreign agency liaison forms contained in GN 01704.400GN 01704.990, return to Centrelink any request that does not indicate that it is needed to process a claim under the agreement unless

  • written consent to disclose in attached or

  • the file contains an SSA-2490 signed by the claimant.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201744235
GN 01744.235 - Facts About the Australian Liaison Form AUS/USA 3 - 05/02/2014
Batch run: 05/02/2014
Rev:05/02/2014