Program Operations Manual System (POMS)
TN 10 (10-18)
INITIAL AWARD CLAIMANT FULLY INSURED WITHOUT FOREIGN COVERAGE (F15)
(Requested)
Caption: Your Benefits
(1) for benefits using work covered by the U.S. only. Under our agreement with (2) , no U.S. benefits may be paid using work covered by (3) if (4) for benefits without it.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary's Name qualifies
Choice 2: You qualify
Fill-in (2) - Requested As A One Position Alpha Character Name of Country (under agreement)
Choice 1: (A) Italy
Choice 2: (B) Germany
Choice 3: (C) Switzerland
Choice 4: (D) Norway
Choice 5: (E) Sweden
Choice 6: (F) Canada
Choice 7: (G) Austria
Choice 8: (H) Belgium
Choice 9: (I) United Kingdom
Choice 10: (J) Spain
Choice 11: (K) France
Choice 12: (L) Portugal
Choice 13: (M) Netherlands
Choice 14: (N) Finland
Choice 15: (O) Ireland
Choice 16: (P) Luxembourg
Choice 17: (Q) Greece
Choice 18: (R) Chile
Choice 19: (S) Korea
Choice 20: (T) Australia
Choice 21: (U) Japan
Choice 22: (V) Denmark
Choice 23: (W) The Czech Republic
Choice 24: (X) Poland
Choice 25: (Y) Slovakia
Choice 26: (Z) Hungary
Choice 28: (1) Brazil
Choice 29: (2) Uruguay
Fill-in (3) - Systems Generated
Same as Fill-in (2)
Fill-in (4) - Systems Generated
Choice 1: she qualifies
Choice 2: he qualifies
Choice 3: you qualify
TOTALIZATION BENEFITS AWARDED (F03)
(System Generated)
Caption: We considered foreign payments
(1) applied for benefits under the agreement between the United States and (2) . (3) for U.S. Social Security benefits based on combined credits from both countries.
Fill-in values:
Fill-in (1) – Systems Generated
Choice 1: Beneficiary's full name
Choice 2: your
Fill-in (2) – Systems Generated
Choice 1: (A) Italy
Choice 2: (B) Germany
Choice 3: (C) Switzerland
Choice 4: (D) Norway
Choice 5: (E) Sweden
Choice 6: (F) Canada
Choice 7: (G) Austria
Choice 8: (H) Belgium
Choice 9: (I) United Kingdom
Choice 10: (J) Spain
Choice 11: (K) France
Choice 12: (L) Portugal
Choice 13: (M) Netherlands
Choice 14: (N) Finland
Choice 15: (O) Ireland
Choice 16: (P) Luxembourg
Choice 17: (Q) Greece
Choice 18: (R) Chile
Choice 19: (S) Korea
Choice 20: (T) Australia
Choice 21: (U) Japan
Choice 22: (V) Denmark
Choice 23: (W) The Czech Republic
Choice 24: (X) Poland
Choice 25: (Y) Slovakia
Choice 26: (Z) Hungary
Choice 28: (1) Brazil
Choice 29: (2) Uruguay
Fill-in (3) – Systems Generated
Choice 1: He qualifies
Choice 2: She qualifies
Choice 3: You qualify
APPLICATION CLAIM FOR ANOTHER COUNTRY (F11)
(Requested/Generated)
Caption: Other Social Security Benefits
(1) application is also a claim for social insurance benefits from (2) . (3) will let you know if (4) for benefits under (5) laws.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary name possessive
Choice 4: Your
Fill-in (2) - Requested As A One Position Alpha Character Name of Country
Choice 1: (A) Italy
Choice 2: (B) Germany
Choice 3: (C) Switzerland
Choice 4: (D) Norway
Choice 5: (E) Sweden
Choice 6: (F) Canada
Choice 7: (G) Austria
Choice 8: (H) Belgium
Choice 9: (I) United Kingdom
Choice 10: (J) Spain
Choice 11: (K) France
Choice 12: (L) Portugal
Choice 13: (M) Netherlands
Choice 14: (N) Finland
Choice 15: (O) Ireland
Choice 16: (P) Luxembourg
Choice 17: (Q) Greece
Choice 18: (R) Chile
Choice 19: (S) Korea
Choice 20: (T) Australia
Choice 21: (U) Japan
Choice 22: (V) Denmark
Choice 23: (W) the Czech Republic
Choice 24: (X) Poland
Choice 25: (Y) Slovakia
Choice 26: (Z) Hungary
Choice 28: (1) Brazil
Choice 29: (2) Uruguay
Fill-in (3) - Systems Generated
Choice 1: That country
Fill-in (4) - Systems Generated
Choice 1: she qualifies
Choice 2: he qualifies
Choice 3: you qualify
Fill-in (5) - Systems Generated
Choice 1: its
Choice 2: their