Effective Dates: 05/09/1994 - Present Previous | Next

Basic (02-94)

GN 01734.235 Facts About the Luxembourg Liaison Form LUX/USA 3

A. List of form lux/USA 3 functions

The Luxembourg agencies use the liaison form to:

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    transmit material to OIO,

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    send information to OIO, and

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    request information from OIO.

B. Description of the LUX/USA 3

Following is a description of the items on the form LUX/USA 3:

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    Parts I and II contain information about the worker and claimants. The “verified” blocks in Part II are checked if the Luxembourg agency has verified the dates for their claim.

Note: Dates are shown in year/mo/day format.

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    Part III provides information about material that the Luxembourg agency is transmitting with the liaison form.

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    Part IV lists the information that the Luxembourg agency is requesting from SSA. This section includes a Privacy Act Authorization to release information to Luxembourg.

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    Part V contains remarks.

C. Exhibit

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201734235
GN 01734.235 - Facts About the Luxembourg Liaison Form LUX/USA 3 - 05/09/1994
Batch run: 10/17/2016
Rev:05/09/1994