TN 13 (09-93)
RS 02001.798 How a Certificate of Coverage is Issued - U.S. Luxembourg Agreement
This is how the U.S. and Luxembourg process requests for certificates of coverage.
1. U.S. Certificates
SSA sends two copies of the certificate to the person requesting the certificate (only one copy sent to self-employed person).
SSA also sends a copy of the certificate to the Luxembourg authorities.
The employer in Luxembourg or self-employed person receives the certificate and retains in files.
The employer in Luxembourg or self-employed person presents the certificate to the Luxembourg authorities if requested to do so.
2. Luxembourg Certificates
The Luxembourg agency sends a copy to the person requesting the certificate.
The Luxembourg agency also sends a copy to SSA.
If the person is employed, employer in the U.S. retains in files and presents it to the IRS upon request.
If the person is self-employed, the worker attaches a photocopy of the certificate to the schedule SE that is filed with the income tax return each year (see RS 02001.780B.).
B. PROCEDURE - WHERE TO WRITE
The employer or self-employed person should take the appropriate action below to obtain a certificate of coverage.
1. U.S. Certificate
Write to SSA at the address in RS 02001.790A.
2. Luxembourg Certificate
Write to the General Inspectorate for Social Security at the address in RS 02001.790A.
C. PROCEDURE - REQUIRED INFORMATION
Provide the following information when writing to obtain a certificate of coverage.
full name (including maiden name for married women),
Social Security number (U.S. number for U.S. certificate and Luxembourg number for Luxembourg certificate)
country of citizenship
date and place of birth
country of permanent residence
name and address of employer in both countries (if self-employed, nature of activity and address of trade or business in both countries)
date and place of hire by sending company, if employed
beginning date and ending date (if known) of employment or self-employment in the other country
statement indicating whether the employee will remain an employee of the U.S. company while working in Luxembourg or will become an employee of a Luxembourg company.
IMPORTANT: If the worker will be an employee of a Luxembourg affiliate of an American employer, the request must indicate whether the American employer has entered into an agreement with the Internal Revenue Service under section 3121(l) of the Internal Revenue Code and, if yes, the effective date of such an agreement.