Form Details
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Application for Benefits Under a U.S. International Social Security Agreement - Form SSA-2490-BK is completed by applicants for benefits from the United States under any Social Security agreement who are applying for those benefits through a U.S. claims taking facility such as a Social Security Field Office or Foreign Service Post. With the exception of claims for foreign benefits under that agreement with Canada, Form SSA-2490-BK will also be completed by applicants filing for foreign benefits at a U.S. claims taking facility. Applicants for benefits from Canada will continue to complete a special Canadian application Form (ssa-1294-CN, OMB Number 0960-0371) unique to that agreement.
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