TN 5 (06-14)

A. Process for issuing certificates of coverage

The following steps describe the process for issuing a certificate of coverage:

1. The employer, in the case of employment, or the worker, in the case of self-employment, writes to the appropriate authority requesting a certificate.

   NOTE: For U.S. requests, the employer's or worker's representative (e.g., attorney or accounting firm) may request the certificate on the employer's or worker's behalf. A request from an employee is not acceptable.

2. The Social Security Administration (in the case of U.S. certificates) or the Sociálna Poistovna (in the case of Slovak certificates) issues the certificate, if appropriate.

3. The issuing agency sends the original, and one copy, to the requestor.

4. The employer or worker retains the certificate in their files and presents it to the tax authorities in the other country if requested to do so. If the worker is a self-employed U.S. citizen, or national who is subject only to Slovak laws under the agreement, he or she must attach a photocopy of the Slovak certificate to the Schedule SE filed with his or her U.S. Federal income tax return each year.

B. Procedure for issuing certificates of coverage

1. Required information for a certificate

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

• full name of worker;

• Social Security Number when requesting a U.S. certificate or the Birth Registration Number when requesting a Slovak certificate;

• country of citizenship;

• date and place of birth;

• country of permanent residence;

• name and address of employer in both countries if employed, or address of trade or business in both countries if self-employed;

• nature of self-employment activity, if self-employed;

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

• beginning and ending dates of employment or self-employment in the other country.

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

2. Where to send request for certificate

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

a. For U.S. certificates

If preferred, the requestor may fax the request, to 410-966-1861. Please note this fax number is only for requesting U.S. certificates of coverage or exemption letters.

NOTE: Employers who have access to the Internet can request U.S. certificates of coverage over the Internet. For more information see U.S. Certificates of Coverage. Only an employer can use the online form to request a certificate of coverage. A self-employed person must submit a request by mail or fax.

b. For Slovak certificates

C. References

• RS 01901.070 Employment Outside the United States for a Foreign Affiliate or Subsidiary of an American Employer

• RS 02002.305 Certificates of Coverage under the Agreement with the Slovak Republic