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Be sure to provide the following information in your letter:

© Full name;

© Date and place of birth;

© Citizenship;

© Country of permanent residence;

© US. and/or U.K. Social Security number;

© Nature of self-employment activity;

© Dates the activity was or will be performed; and

* Name and address of your trade or business in both countries.

Effective Date Of Coverage Exemption

The certificate of coverage you receive from one country will show the effective date of your exemption from paying Social Security
taxes in the other country. Generally, this will be the date you began working in the other country.

Certificates of coverage issued by the United Kingdom should be retained by the employer in the United States in case of an audit
by the Internal Revenue Service (IRS). No copy should be sent to the IRS unless specifically requested by IRS. However, a self-
employed person must attach a photocopy of the certificate to his or her income tax return each year as proof of the U.S.
exemption.

Copies of certificates of coverage issued by the United States will be provided for both the employee and employer. It will be their
responsibility to present the certificate to the U.K. authorities when requested to do so. To avoid any difficulties, your employer (or
you, if you are self-employed) should request a certificate as early as possible, preferably before your work in the other country
begins.

If you or your employer request a certificate of coverage, you should read the Privacy Act and Paperwork Reduction Act statements
below.

Authority to collect information for a certificate of coverage
Privacy Act

[The Privacy Act requires us to notify you that we are authorized to collect this information by section 233 of the Social Security Act.

hile it is not mandatory for you to furnish the information to the Social Security Administration (SSA), a certificate of coverage
cannot be issued unless a request has been received. The information is needed to enable SSA to determine if work should be
covered only under the U.S. Social Security system in accordance with an international agreement. Without the certificate, work
Imay be subject to taxation under both the U.S. and the foreign Social Security systems.

Paperwork Reduction Act Notice

[This information collection meets the clearance requirements of 44 U.S.C. section 3507, as amended by section 2 of the Paperwork

Reduction Act of 1995. You are not required to answer these questions unless we display a valid Office of Management and Budget

(OMB) control number. We estimate that it will take you about 30 minutes to read the instructions, gather the necessary facts, and
rite down the information to request a certificate of coverage.

Monthly benefits

The following table shows the various types of Social Security benefits payable under the U.S. and U.K. Social Security systems and
briefly describes the eligibility requirements that normally apply for each type of benefit. If you don't meet the normal requirements

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P.O. Box 17769
Baltimore, Maryland 21235-7769
USA.

For information about the United Kingdom's Social Security programs:

© If you live in the United Kingdom, contact your nearest office of the Department for Work and Pensions;
© Ifyou live outside the United Kingdom, and want information about benefits, contact:

Department for Work and Pensions
Pensions and Overseas Directorate
Tyneview Park

Whitley Road

Benton

Newcastle upon Tyne NE98 1BA
ENGLAND; or

© If you live outside the United Kingdom and want advice about paying contributions:

Inland Revenue

National Insurance
Contributions Office

Centre for Non-Residents
Newcastle upon Tyne NE98 1ZZ
ENGLAND

If you don't wish to file a claim for benefits but would like more information about the agreement, write to:

Social Security Administration
Office of International Programs
P.O. Box 17741

Baltimore, Maryland 21235-7741
USA.

For additional information visit our website: www.socialsecurity.gov/international.

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retirement age. Reduced benefit as early payable at age 60 based on ex-husband's

as age 62. Must be unmarried and have contributions provided she has also

been married to worker for at least 10 contributed to the U.K. system.

years. Remarriage after age 60 will not affect
entitlement.

Divorced Husband-Same as divorced Divorced Husband-At age 65; other
wife. requirements same as divorced wife.
Children-If unmarried, up to age 18 (age Children-Up to age 16 (age 19 for certain
19 if in an elementary or secondary school students).
full time) or any age if disabled before age
22.

Survivors benefits

United States United Kingdom

Widow-Full benefit at full retirement age Widow-Full benefit at age 55 or at any
or at any age if caring for the deceased's age if caring for a dependent child of the
entitled child under 16 (or disabled before worker. Reduced benefit as early as age

age 22). Reduced benefit as early as age

45. Benefit may continue if remarriage

60 (or 50 if disabled) if not caring for child.occurs after age 60.

Benefits may be continued if remarriage

occurs after age 60 (or age 50 if disabled).

Widower-Same as widow.

Divorced Widow or widower-Same as
widow or widower if marriage lasted at
least 10 years.

Children-Same as for children of retired
or disabled worker.

Lump-Sum Death Benefit-A one-time
payment not to exceed $255 payable on

Widower-Benefit payable at age 65, if
widowed before age 65 and also
contributed to the U.K. system.
Divorced Widow or widower-No
provision.

Children-Same as for children of retired
or disabled contributors.

Lump-Sum Death Payment-No
provision.

the death of an insured worker.

How Benefits Can Be Paid

If you have Social Security credits in both the United States and the United Kingdom, you may be eligible for benefits from one or
both countries. If you meet all the basic requirements under one country's system, you will get a regular benefit from that
country. If you don't meet the basic requirements, the agreement may help you qualify for a benefit as explained below.

© Benefits from the U.S—If you do not have enough work credits under the U.S. system to qualify for regular benefits, you

may be able to qualify for a partial benefit from the United States based on both U.S. and U.K. credits. However, to be eligible

to have your U.K. credits counted, you must have earned at least six credits (generally one and one-half years of work) under

the U.S. system. If you already have enough credits under the U.S. system to qualify for a benefit, the U.S. cannot count your

U.K. credits.

© Benefits from the U.K.—The United Kingdom provides benefits through a two-tier program:
1. The first tier, called the basic pension, is payable to workers who meet a minimum length of work requirement. Under

the agreement, if you do not have enough credits under the U.K. system, your U.S. credits can be counted. To be
eligible to have your U.S. and U.K. credits counted, you must have at least one year of coverage credited under the U.K.
system.

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for these benefits, the agreement may help you to qualify (see "How benefits can be paid" section).

This table is only a general guide. You can get more specific information about U.S. benefits here on our web site, at any U.S. Social

Security office or by calling our toll-free number at 1-800-772-1213. You can get more detailed information about the U.K. system

by writing to the UK. address in "For more information" section of this document or by visiting the web site of the U.K. social

security system.

Under U.S. Social Security, you may earn up to four credits each year depending on the amount of your covered earnings. For
example, in 2005, you get one credit for each $920 of your covered annual earnings up to a maximum of four credits for the
year. Under the U.K. system, credits are measured in weeks. To simplify the information in the table, requirements are shown in

years of credits.

Monthly Benefits And Eligibility Requirements

Retirement or old-age benefits
United States United Kingdom

Worker-Full benefit at full retirement age, Worker-Full benefit at age 65 for men

or reduced benefit as early as age with 44 years of contributions, or reduced

62. Required work credits range from one benefit with 11 years.

and one-half years to 10 years (10 years if Full benefit at age 60 (increasing to age

62 in 1991 or later). 65 between 2010 and 2020) for women
with 40 years of contributions, or reduced
benefit with 10 years.

Disability benefits

United States United Kingdom

Worker-Under full retirement age can get Worker-A contributor who has not retired

benefit if unable to do any substantial can get an invalidity benefit if he or she
gainful work for at least a year. One and _ has been incapable of working for 52
one-half to 10 years credit required weeks during which time he or she was

depending on age at date of onset. Some entitled to statutory sickness pay or short-
recent credits also needed unless worker term incapacity benefits. The contributor
is blind. must have paid a required number of
contributions in a recent tax year.
Family benefits to dependents of retired or disabled people

United States United Kingdom

Wife-Full benefit at full retirement age or Wife-Retirement pension at age 60 based

at any age if caring for the worker's on husband's contributions if she doesn't

entitled child under 16 (or disabled before qualify for a higher pension based on her

age 22). Reduced benefit as early as age own contributions. If under age 60, an

62 if not caring for a child. increased pension is paid to the husband.
An increased invalidity benefit is payable
for a wife in certain circumstances.

Husband-Same as wife. Husband-Wife cannot claim extra
retirement pension for husband, but can
claim increased invalidity benefit in certain
circumstances.

Divorced Wife-Full benefit at full Divorced Wife-Retirement pension

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« The Federal Benefits Unit at the U.S. Embassy in London (phone 207-499-9000) to file for U.S. benefits; or
© Any U.K. Social Security office to file for U.K. benefits.

You can apply with one country and ask to have your application considered as a claim for benefits from the other country.
Information from your application will then be sent to the other country. Each country will process the claim under its own laws--
counting credits from the other country when appropriate--and notify you of its decision.

If you haven't applied for benefits before, you may need to provide certain information and documents when you apply. These
include the worker's U.S. and U.K. Social Security numbers, proof of age for all claimants, evidence of the worker's U.S. earnings in
the past 24 months, and information about the worker's coverage under the U.K. system. You may wish to call the Social Security
office before you go there to see if any other information is needed.

Payment Of Benefits

Each country pays its own benefit. U.S. payments are made by the U.S. Department of Treasury each month and cover benefits for
the preceding month.

Payments under the U.K. system may be paid at different times and for various periods of time depending upon the amount of the
payment and the wishes of the recipient. For more information, contact the appropriate U.K. authorities as shown in "For more
information" section of this document.

Absence From U.S. Territory

Normally, persons who are not U.S. citizens may receive U.S. Social Security benefits while outside the U.S. only if they meet certain
requirements. Under the agreement, however, you may receive benefits as long as you reside in the United Kingdom regardless of
your nationality. If you are not a U.S. or U.K. citizen and live in another country, you may not be able to receive benefits. The
restrictions on U.S. benefits are explained in the publication, Your Payments While You Are Outside The United States (Publication
No. 05-10137).

Appeals

If you disagree with the decision made on your claim for benefits under the agreement, contact any U.K. or U.S. Social Security
office. The people there can tell you what you need to do to appeal the decision.

The U.K. Social Security authorities will review your appeal if it affects your rights under the U.K. system, while U.S. Social Security
authorities will review your appeal if it affects your rights under the U.S. system. Since each country's decisions are made
independently of the other, a decision by one country on a particular issue may not always conform with the decision made by the
other country on the same issue.

For more information

To file a claim for U.S. or U.K. benefits under the agreement, follow the instructions in "Claims for benefits" section.

To find out more about U.S. Social Security benefits or for information about a claim for benefits, contact any U.S. Social Security
office or call our toll-free number at 1-800-772-1213. If you live outside the United States, write to:

Social Security Administration
O10--Totalization

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Social Security

Official Social Security Website

International Programs

Totalization Agreement with the United Kingdom
SSA Publication No. 05-10199, May 2005, ICN 444918 [OMB Approval Number: 0960-0554 Expires 12/31/2016]

Contents

Introduction

Coverage and Social Security taxes
Certificate of coverage

Monthly benefits

AUK. pension may affect your U.S. benefit
What you need to know about Medicare
Claims for benefits

For more information

Introduction

An agreement between the United States and the United Kingdom (U.K.) improves Social Security protection for people who work
or have worked in both countries. It helps many people who, without the agreement, would not be eligible for monthly retirement,
disability or survivors benefits under the Social Security system of one or both countries. It also helps many people who would
otherwise have to pay Social Security taxes to both countries on the same earnings.

The provisions of the agreement that eliminate double Social Security taxation became effective January 1, 1985. The provisions
which permit persons who meet certain conditions to use their work in both countries to qualify for benefits became effective
January 1, 1988. For purposes of the agreement, references to the United Kingdom include England; Scotland; Wales; Northern
Ireland; the Isle of Man; and the Channel Islands of Jersey, Guernsey, Alderney, Herm, and Jethou.

The agreement covers Social Security taxes (including the U.S. Medicare portion) and Social Security retirement, disability and
survivors insurance benefits. It doesn't cover benefits under the U.S. Medicare program or the Supplemental Security Income (SSI)
program.

This document covers highlights of the agreement and explains how it may help you while you work and when you apply for
benefits.

The Agreement May Help You, Your Family And Your Employer

© While you work—If your work is covered by both the U.S. and the U.K. Social Security systems, you (and your employer, if
you are employed) would normally have to pay Social Security taxes to both countries for the same work. However, the
agreement eliminates this double coverage, so you pay taxes to only one system (see the section on "Coverage and Social
Security taxes").

« When you apply for benefits—You may have some Social Security credits in both the United States and the United
Kingdom but not enough to be eligible in one country or the other. The agreement makes it easier to qualify for benefits by
letting you add together your Social Security credits in both countries. For more details, see the section on "Monthly
benefits”.

Coverage and Social Security taxes

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2. The second tier is called the additional pension and is based on both the length of work under the U.K. system and the
amount of earnings. A person can qualify for the additional pension with as little as one year of U.K.
coverage. Therefore, credits under the U.S. system will not be considered when determining eligibility for the additional
pension.

How Credits Get Counted

You don't have to do anything to have your credits in one country counted by the other country. If we need to count your credits
under the U.K. system to help you qualify for a U.S. benefit, we will get a copy of your U.K. record directly from the United Kingdom
when you apply for benefits. If U.K. officials need to count your U.S. credits to help you qualify for a U.K. benefit, they will get a
copy of your U.S. record directly from the Social Security Administration when you apply for the U.K. benefit.

Although each country may count your credits in the other country, your credits are not actually transferred from one country to
the other. They remain on your record in the country where you earned them and can also be used to qualify for benefits there.

Computation Of U.S. Benefit Under The Agreement

When a U.S. benefit becomes payable as a result of counting both U.S. and U.K. Social Security credits, an initial benefit is
determined based on your U.S. earnings as if your entire career had been completed under the U.S. system. This initial benefit is
then reduced to reflect the fact that U.K. credits helped to make the benefit payable. The amount of the reduction will depend on
the number of U.S. credits: the more U.S. credits, the smaller the reduction; and the fewer U.S credits, the larger the reduction.

What you need to know about Medicare

Medicare is the U.S. national health insurance system for people age 65 or older or who are disabled. Medicare has two parts:
hospital insurance (also called "Part A" Medicare) and medical insurance (called "Part B" Medicare). You are eligible for free hospital
insurance at age 65 if you have worked long enough under U.S. Social Security to qualify for a retirement benefit. People born in
1929 or later need 40 credits (about 10 years of covered work) to qualify for retirement benefits.

Although the agreement between the United States and the United Kingdom allows the Social Security Administration to count
your U.K. credits to help you qualify for U.S. retirement, disability or survivor benefits, the agreement doesn't cover Medicare
benefits. As a result, we cannot count your credits in the United Kingdom to establish entitlement to free Medicare hospital
insurance.

For more information about Medicare, call our toll-free number, 1-800-772-1213, and ask for the publication, Medicare
(Publication No. 05-10043) or visit Medicare's website at www.medicare.gov.

Claims for benefits

If you live in the United States and wish to apply for U.S. or U.K. benefits:

© Visit or write any U.S. Social Security office, or
© Phone our toll-free number, 1-800-772-1213, 7 a.m. to 7 p.m. any business day. People who are deaf or hard of hearing may
call our toll-free TTY number, 1-800-325-0778.

You can apply for UK. benefits at any U.S. Social Security office by completing application form SSA-2490.

If you live in the United Kingdom and wish to apply for benefits, contact:

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P.O. Box 17741
Baltimore, Maryland 21235-7741
USA.

If preferred, the request may be sent by FAX to (410) 966-1861. Please note this FAX number should only be used to request
certificates of coverage.

No special form is required to request a certificate but the request must be in writing and provide the following information:

¢ Full name of worker;

© Date and place of birth;

© Citizenship;

© Country of worker's permanent residence;

e US. Social Security number;

© Date of hire;

© Country of hire;

© Name and address of the employer in the U.S. and the U.K.; and
© Date of transfer and anticipated date of return.

In addition, your employer must indicate if you remain an employee of the U.S. company while working in the United Kingdom or if
you become an employee of the U.S. company's affiliate in the United Kingdom. If you become an employee of an affiliate, your
employer must indicate if the U.S. company has an agreement with the Internal Revenue Service under section 3121(I) of the
Internal Revenue Code to pay U.S. Social Security taxes for all U.S. citizens and residents employed by the affiliate and, if yes, the
effective date of the agreement.

Your employer can also request a certificate of U.S. coverage for you over the Internet using a special online request form available
at www.socialsecurity.gov/coc. 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.

To establish your exemption from coverage under the U.S. Social Security system, your employer in the United Kingdom must
request a certificate of coverage (form UK/US 1) from the United Kingdom at this address:

Inland Revenue

National Insurance Contributions Office
Center for Non-Residents

Rooms BP 1301/BP 1302

Bamburgh House

Benton Park View

Longbenton

Newcastle upon Tyne NE98 1ZZ
ENGLAND

The same information required for a certificate of coverage from the United States is needed to get a certificate of coverage from
the United Kingdom except that you must show your U.K. National Insurance number rather than your U.S. Social Security number.

Certificates For Self-Employed People

If you are self-employed and would normally have to pay Social Security taxes to both the U.S. and the U.K. systems, you can
establish your exemption from one of the taxes by writing to:

© Ifyou reside in the United States, the Social Security Administration at the address in "Certificates for employees" section; or
© If you reside in the United Kingdom, Inland Revenue at the address in “Certificates for employees" section.

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© Sent you to work in the U.S. for more than U.S.

five years

© Hired you in the U.S.

For a non-U.K. employer

For the U.K. government and you are a:

U.K. national
U.S. national

You are self-employed and you:

© Reside in the U.S.

Reside in the U.K.

US.

US.

UK.

US.

US.

UK.

If this table does not seem to describe your situation and you are:

© Working in the U.S.

© Working in the U.K.

Note

Write to the U.S. address in
"Certificates for employees" section
for further information.

Write to the U.K. address in "For
more information” section for
further information.

As the table indicates, a U.S. worker employed in the United Kingdom can be covered by U.S. Social Security only if he or she

works for a U.S. employer. A U.S. employer includes a corporation organized under the laws of the United States or any state, a

partnership if at least two-thirds of the partners are U.S. residents, an individual who is a resident of the U.S. or a trust if all the
trustees are U.S. residents. The term also includes a foreign affiliate of a U.S. employer if the U.S. employer has entered into an
agreement with the Internal Revenue Service under section 3121(I) of the Internal Revenue Code to pay Social Security taxes for

U.S. citizens and residents employed by the affiliate.

Certificate of coverage

A certificate of coverage issued by one country serves as proof of exemption from Social Security taxes on the same earnings in the

other country.

Certificates For Employees

To establish an exemption from compulsory coverage and taxes under the U.K. system, your employer must request a certificate of

coverage (form US/UK 1) from the U.S. at this address:

Social Security Administration
Office of International Programs

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Before the agreement, employees, employers and self-employed persons could, under certain circumstances, be required to pay
Social Security taxes to both the United States and the United Kingdom for the same work.

Under the agreement, if you work as an employee in the United States, you normally will be covered by the United States, and you
and your employer will pay Social Security taxes only to the United States. If you work as an employee in the United Kingdom, you

normally will be covered by the United Kingdom, and you and your employer pay Social Security taxes only to the United Kingdom.

On the other hand, if your employer sends you from one country to work for that employer or an affiliate in the other country for
five years or less, you will continue to be covered by your home country and you will be exempt from coverage in the other
country. For example, if a U.S. company sends an employee to work for that employer or an affiliate in the United Kingdom for no
more than five years, the employer and the employee will continue to pay only U.S. Social Security taxes and will not have to pay in
the United Kingdom.

If you are self-employed and reside in the United States or the United Kingdom, you generally will be covered and taxed only by
the country where you reside.

People working on the U.K. continental shelf are considered to be working in the United Kingdom.

Summary Of Agreement Rules

The following table shows whether your work is covered under the U.S. or U.K. Social Security system. If you are covered under U.S.
Social Security, you and your employer (if you are an employee) must pay U.S. Social Security taxes. If you are covered under the
U.K. system, you and your employer (if you are an employee) must pay U.K. Social Security taxes. "Certificate of coverage" section
explains how to get a form from the country where you are covered that will prove you are exempt in the other country.

Your work status Coverage and taxes

You are working in the U.K.:

For a U.S. employer who:

US.
© Sent you to work in the U.K. for five years
or less
U.K.
© Sent you to work in the U.K. for more than
five years
U.K.
© Hired you in the U.K.
For a non-U.S. employer U.K.
For the U.S. government and you are a:
U.S. national USS. (either Social Security or federal
retirement program)
U.K. national U.K.
You are working in the U.S.:
For a U.K. employer who:
U.K.

* Sent you to work in the U.S. for five years
or less

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