Contract Coverage Under Title Il OMB No, 1545-0197
r= 2032 of the Social Security Act ee

(Rev. December 1985)
rtment of the Treasur (For use by an American employer to extend social security coverage to File three copies

pavesie}-ihhadly Mirna United States citizens and residents employed by Its forelgn affiliates.)

Name of American employer Employer Identification number

Address (Number and street)

City, state, and ZIP code

This Form 2032 is filed as (please check applicable box(es)):
C An original (new) agreement.
This agreement is effective for services performed on and after (for original agreements only, check one):
C The first day of the calendar quarter in which the Service Center Director signs this agreement.
C1 The first day of the calendar quarter following the calendar quarter in which the Service Center Director signs this agreement.
O Anamendment to an agreement previously entered into.
O Anelection to apply the rules in effect after April 20, 1983, to current agreements in effect on that date. By making this election, U.S.
resident aliens as well as citizens will be covered by social security.

{f this is an election or an amendment to a previously filed agreement, please give the following information:

on
(Location where previous Form 2032 filed) (Date Service Center Director signed original agreement on Form 2032)

This agreement extends the Federal insurance system under Title Il of the Social Security Act to certain services performed outside the
United States by U.S. citizens and resident aliens employed by any of the foreign affiliates listed below. For an amendment to an
agreement without making the election to apply the post-April 20, 1983, rules, this amendment extends social security coverage to
certain services performed outside the U.S. by U.S. citizens employed by any of the foreign affiliates listed below.

1 Name and address of foreign affiliate 3 Name and address of foreign affiliate

2 Name and address of foreign affiliate 4 Name and address of foreign affiliate

Note: /f this agreement includes more than four foreign affiliates, attach a separate sheet of paper identified as a part of this agreement
with the name and address of each additional foreign affiliate.

Estimated number of employees to be initially covered by this agreement, amendment, or election:
nonagricultural; .................- agricultural.

This agreement applies to all services performed outside the United States by each U.S. citizen or resident employed by any of the
foreign affiliates named. However, the agreement applies to such services only to the extent that payments to each employee for the
services would be considered wages if paid by the employer for services performed in the United States. This agreement does not apply to
any service that is considered employment for purposes of the employee tax and the employer tax under the Federal Insurance
Contributions Act.

For an original agreement, an amendment to an agreement that was entered into after April 20, 1983, or an election to apply the rules in
effect after April 20, 1983, to agreements in effect on that date, the American employer declares that it owns at least a 10% interest
(directly or through one or more entities) in the voting stock or profits of each foreign entity named above. It also declares that Code section
3121(I) does not prevent this agreement.

For an amendment to an agreement in effect on April 20, 1983, without making the election to apply the new rules in effect after that
date, the domestic corporation declares that (1) it owns at least 20% of the voting stock of each foreign corporation named above, or (2) it
owns at least 20% of the voting stock of a foreign corporation that owns more than 50% of the voting stock of each foreign corporation
named above. It also declares that Code section 3121() does not prevent this agreement.

The American employer agrees:

(1) To pay amounts equal to the taxes that would be imposed by Code sections 3101 and 3111 if the payment for the services were
considered wages;

(2) To pay, on written notification and demand, amounts equal to the interest, additions to taxes, and penalties that would apply if the
payment for the services were considered wages; and

(3) To comply with all regulations under Code section 3121(I).

This agreement (or amended agreement or election) is entered into under the provisions of section 3121(|) of the Internal Revenue Code
and the applicable regulations.

‘Signature of individual authorized to enter into this agreement for Title Date
‘American employer
Director, internal Revenue Service Center Tocation Date

For Paperwork Reduction Act Notice, see back of this page. Form 2032 (Rev. 12-85)


Form 2032 (Rev. 12-85)

Page 2

Paperwork Reduction Act
Notice

We ask for this information to carry out the
Internal Revenue laws of the United States.
We need it to ensure that taxpayers are
complying with these laws and to allow us to
figure and collect the right amount of tax. If
you want the employees of your foreign
affiliate to be covered under social security,
you are required to give us this information.

General Instructions

(Section references are to the Internal
Revenue Code.)

Changes You Should Note.—Before April
21, 1983 (old rules), only domestic
corporations could enter into this
agreement to cover only U.S. citizens
employed by foreign subsidiaries. A foreign
subsidiary, for purposes of the agreement,
was defined as (1) a foreign corporation in
which at least 20% of the voting stock was
owned by the domestic corporation, or (2) a
foreign corporation in which more than 50%
of the voting stock was owned by another
foreign corporation in which the domestic
corporation owned at least 20% of the
voting stuck.

After April 20, 1983 (new rules), any
American employer (no longer limjted toa
domestic corporation) can enter into this
agreement to cover U.S. resident aliens as
well as U.S. citizens employed by a foreign
affiliate. A foreign affiliate, for purposes of
this agreement, is any foreign entity (no
longer limited to a foreign corporation) in
which the American employer owns at least
a 10% interest (directly or through one or
more entities) in the voting stock or profits.

Adomestic corporation having an
agreement in effect that was entered into
before April 21, 1983, can now elect to
apply the new rules to such agreements. If a
domestic corporation makes this election,
social security coverage will be extended to
U.S. resident alien employees of any foreign
subsidiary for which U.S. citizens are
currently covered by an existing agreement.
In addition, the election allows a domestic
corporation to extend social security
coverage to U.S. citizens and resident aliens
employed by a foreign entity that did not
qualify for coverage under the old 20%
ownership rules, but that now qualifies
under the 10% ownership rules.

Purpose of Form

An American employer should use this form
to (1) enter into the agreement specified in
section 3121(I) to extend coverage under
the Social Security Act to U.S. citizens and
resident aliens employed abroad by foreign
affiliates, (2) amend a previous agreement,
or (3) elect to apply the rules in effectefter
April 20, 1983, to agreements in effect on
that date.

An American employer, for purposes of
this agreement, is an employer that is (1)
the United States or any instrumentality
thereof, (2) an individual who is a resident
of the United States, (3) a partnership if
two-thirds or more of the partners are
tesidents of the United States, (4) a trust if
all the trustees are residents of the United
States, or (5) a corporation organized under
the laws of the United States or of any
state.

Where to File

File three copies of this form with the
Internal Revenue Service Center for the
state where the American employer's
principal place of business in the United
States is located as listed below. (An
American employer already filing Form 941,
Employer's Quarterly Federal Tax Return,
should file Form 2032 with the Internal
Revenue Service Center where the
employer files Form 941 and should enter
on Form 2032 its employer identification
number as shown on Form 941.)

Use the following
Internal Revenue
Service Center
address

If your principal
place of business
is located in

v v

Alabama, Florida, Georgia,
Mississippi, South Carolina

New Jersey, New York City and
New York counties of Nassau,
Rockland, Suffolk, and
Westchester

New York (all other counties),
Connecticut, Maine,
Massachusetts, Minnesota,
New Hampshire, Rhoae Island,
Vermont

Atlanta, GA 31101

Holtsville, NY 00501

Andover, MA 05501

Hlinois, lowa, Missour!,

Wisconsin Kansas City, MO 64999

Delaware, District of Columbia,
Maryland, Pennsylvania Philadelphia, PA 19255

Cincinnati, OH 45999

Kentucky, Michigan, Ohio,
West Virginia

Kansas, Louisiana, New
Mexico, Oklahoma, Texas

‘Alaska, Arizona, California
(counties of Alpine, Amador,
Butte, Calaveras, Colusa,
Contra Costa, Del Norte, El
Dorado, Glenn, Humboldt,
Lake, Lassen, Marin,

Mendocino, Modoc, Napa,
Nevada, Placer, Plumas,
Sacramento, San Joaquin,
Shasta, Sierra, Siskiyou,
Solano, Sonoma, Sutter,
Tehama, Trinity, Yolo, and
Yuba), Colorado, Idaho,
Montana, Nebraska, Nevada,
North Dakota, Oregon, South
Dakota, Utah, Washington,
Wyoming

Austin, TX 73301

Ogden, UT 84201

California (all other counties),

Hawaii Fresno, CA 93888

‘Arkansas, Indiana, North

Carolina, Tennessee, Virginia Memphis, TN 37501

American employers in Guam, American
Samoa, the Virgin Islands, or Puerto Rico
should file this form with the U.S. Internal
Revenue Service Center, Philadelphia, PA
19255.

Completing Form 2032

Complete Form 2032 in triplicate. Each
copy of the form must be signed and dated
by the individual authorized to enter into the
agreement, amendment, or election. Attach
to the form evidence showing the authority
for such individual to sign the form.
Corporations must include a certified copy
of the minutes of the meeting of the board
of directors.

After the Director of the Internal Revenue
Service Center signs and dates the form, it

constitutes the agreement, amendment, or
election authorized by section 3121(1). The
Internal Revenue Service will return one
copy of Form 2032 to the American
employer, send one copy to the Social
Security Administration, and keep one copy
with all related papers.

Original Agreements.—Check the box for
an original (new) agreement. Also check the
box to designate when the agreement is to
take effect.

Amending Agreements. —You may amend
an agreement at any time to extend
coverage to any foreign affiliate not covered
by an existing agreement. File Form 2032 in
triplicate, and check the box on the form to
signify an amendment. If you amend an
agreement entered into on or before April
20, 1983, without making the election to
apply the rules in effect after that date, the
agreement and amendments shall continue
to be governed by the rules in effect before
April 21, 1983.

Effective Date.—If you file an
amendment to an agreement on Form 2032
to include foreign affiliates not previously
covered, and if the service center director
signs the amendment during the quarter for
which the original agreement is first
effective or during the first month following
that quarter, the amendment will be
effective as of the effective date of the
original agreement. But if the amendment is
signed by the service center director after
the end of the fourth month for which the
original agreement is in effect, the
amendment will not be effective until the
first day of the quarter following the one in
which the service center director signed the
amendment.

Election to Apply Post-April 20, 1983,
Rules.—A domestic corporation having an
agreement in effect that was entered into
before April 21, 1983 (old agreement), may
elect to have the rules in effect after April
20, 1983, apply to the old agreement. File
Form 2032 in triplicate, and check the box
for an election.

If you make the election to apply the
post-April 20, 1983, rules to existing
agreements entered into on or before that
date, the election will be effective for all
foreign entities covered by the agreement.
By making the election, U.S. resident alien
employees as well as U.S. citizen employees
will be covered by the agreement.

To extend coverage to any foreign entity
not covered by an agreement, indicate the
name and address of the foreign entity on
the form in the space provided, and check
the box for the election and the box for the
amended agreement.

Effective Date. —Generally, the election
will be effective on the day following the
quarter in which the election is signed by
the service center director.

Terminating an Agreement

Once an agreement has been in effect for at
least 8 years, the American employer can
revoke it with respect to any or all foreign
affiliates by giving 2 years advance notice in
writing, in accordance with section 3121(I)
and the applicable regulations.