Advise the person to provide the following information when writing to get a certificate of coverage:

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  Full name of worker;

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  Date and place of birth;

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  Country of permanent residence;

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  Country of citizenship;

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  U.S. Social Security number;

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  Danish Central Personal Registration (CPR) number, if known;

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  Name, relationship, and date of birth of family members accompanying the worker;

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  Name and address of employer in both countries if employed or address of trade or business in both countries if self-employed;

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  Nature of trade or business, if self-employed;

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  Date and place of hire by employer transferring the employee, if employed;

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  Beginning date and ending date of employment or self-employment in the other country; and

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  A statement indicating whether the employee remains an employee of the U.S. company while working in Denmark or becomes an employee of a Danish company.

  NOTE: If the worker is an employee of a Danish affiliate of an American employer, the request must indicate whether the American employer has entered into an agreement with the Internal Revenue Service (IRS) under section 3121(l) of the IRS Code and, if yes, the effective date of such an agreement.

Advise the person to send the request to the appropriate address below.