TN 15 (02-95)
Certificates of coverage are the forms that SSA and the Dutch authorities issue to
workers who would otherwise have to pay Social Security taxes to both countries on
the same earnings. A certificate of coverage issued by one country serves as proof
that the worker named on the certificate is:
subject to the laws of the country issuing the certificate and
exempt from Social Security coverage and contributions on the same earnings in the
The following agencies are responsible for issuing certificates of coverage.
issues the certificates of U.S. coverage.
The Sociale Verzekeringsbank (Social Insurance Bank)
issues the certificates of Dutch coverage.