Please rate Ssa 2490 Bk Form 04-2025
Complete Part 1 in all cases. Complete Part 2 only if you are claiming benefits from a foreign country.
If the worker is deceased: this application should be completed by one of the worker's survivors who is claiming benefits.
Item 11: complete item 11 only if you are not the worker. If you are the worker, leave this question blank and go on to item 12.
Witnesses: if signed by mark (X), two witnesses to the signing who know the applicant must sign below, giving their full addresses.
Children: children include natural children, step-children and adopted children plus grandchildren living in the same household as the worker.
Page 1: remove page 1 of this form before completing the rest of the application; after it is completed and signed, staple the detached page to the application.
| Question | Answer |
|---|---|
| Form Name | Form SSA-2490-BK |
| Form Length | 8 pages |
| Fillable? | Yes |
| Fillable fields | 250 |
| Avg. time to fill out | 42 min |
| Edition | 04-2025 |
| Issuing agency | Social Security Administration |
| Other names | SSA-2490-BK, SSA-2490, SSA 2490, SSA2490, Form SSA-2490-BK, Application for Benefits Under a U.S. International Social Security Agreement |
| Official source | Form SSA-2490-BK (Rev 04-2025), Social Security Administration |
Ssa 2490 Bk Form isn’t the one you’re looking for?
Please rate Ssa 2490 Bk Form 04-2025
