TN 16 (11-96)

A. U.S. United Kingdom Agreement — General

A certificate of coverage serves as proof that the worker identified on the certificate is covered in the country which issued the certificate and is, therefore, exempt from social security taxes in the other country for the period noted on the certificate. To obtain a certificate of coverage from a country, the employer, employee or self-employed person must send a written request to the agency of that country which issues the certificate. Requests for certificates of coverage from the U.S. should be mailed to:

Requests for certificates of coverage from the United Kingdom should be mailed to:

B. Information Required

The following information about the worker must be given when requesting a certificate from either country:

1. Full name

2. Date and place of birth

3. Country of citizenship

4. Country of residence

5. U.S. social security number (for U.S. certificates)

6. U.K. social security number (for U.K. certificates)

7. Name and address of employer in both countries (if self-employed, address and nature of activity).

8. Beginning and ending date of employment/self-employment in the other country.

C. Disposition of Copies

When a U.S. certificate is issued, an employee and employer copy will be sent to the employer or self-employed person. It will be the responsibility of the employer or self-employed person to present the certificate to the United Kingdom authorities when necessary.

When a United Kingdom certificate is issued, the employer or self-employed person will be provided with a copy. It is the responsibility of the employer or self-employed person to retain the copy and to present it to IRS when requested to do so.