Basic (09-18)
GN 01756.320 Hungarian Medical Exam Reimbursement Form
The Hungarian liaison agency will use the SSA 2960 HU-USA 3 (U.S.A. - Hungary Agreement
on Social Security Transmittal/Request/Certification Form) for reimbursement of medical
expenses regarding requests for exams. They will attach a letter showing the reimbursement
amount they are requesting.