If an applicant wishes to file for Slovak benefits and does not bring the special
form for Slovak benefits (SK/USA 2) to the FO:
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obtain a copy of Form SK/USA 2 from the Social Insurance Agency website.
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print Form SK/USA2 and instructions and give to the applicant to complete;
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provide assistance in completing the Form SK/USA 2;
NOTE: Most applicants filing for Slovak benefits should be able to complete the application
without assistance by using the instructions provided with the application.
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witness the applicant signature on the form.
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accept, date and location stamp the application.
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photocopy and certify the photocopied application.
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request an “Informational/Certified Earnings Record” (ICERS) per MSOM ICERS 001.004.
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photocopy and certify the photocopies of any documents (evidence) the Slovak agency
has requested that the applicant include with the Slovak claim.
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send the ICERS and the original SSA date and location-stamped Slovak application and
any additional SSA-certified claims material (photocopies of evidence) to the Office
of Earnings and International Operations (OEIO)/Division of International Operations
(DIO) in Baltimore at the following address:
Social Security Administration
OEIO/DIO
P.O. Box 17769
Baltimore, Maryland 21235-7769
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complete the Modernized Development Worksheet (MDW) screen to show the date the FO
sent the claim for Slovak benefits to OEIO/DIO.
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show “Totalization” as the ISSUE when completing the MDW screen.
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return to the claimant the photocopy of the Form SK/USA 2 and any original evidentiary
documents submitted by the claimant.
Once OEIO/DIO receives the claim, OEIO/DIO will send the claim directly to the Slovak
agency along with the evidence and the worker’s U.S. coverage record.