Workers who are exempt from US or Czech social security contributions under the agreement must document their exemption by obtaining a country coverage certificate that continues to cover it. For example, an American worker temporarily posted to the Czech Republic needs a coverage certificate issued by the SSA to prove his exemption from Czech social security contributions. Conversely, a worker living in the Czech Republic who works temporarily in the United States would need a certificate from the Czech Social Security Administration (Ceské spré va soci-ln-ho zabezpecen” as proof of the exemption from the US social security tax. The guarantee certificate you receive from one country indicates the effective date of your exemption from payment of social security contributions in the other country. In general, this is the date you started working in the other country, but not before the agreement came into force. The totalization agreements are intended to coordinate the taxation of social security and benefits for people sharing their careers between the United States and another country. In the absence of an agreement, a worker from one country who works in the other may be forced to pay social security taxes to the two countries with the same income. The employer can also pay both countries. Like previous U.S. agreements, the agreement with the Czech Republic eliminates this double taxation on social security by assigning a worker`s social security to only one country. Form IN/CZ 4 (PDF 561.72 kB) This form is used as an application for an Old Age or Indian Survival Pension or a total permanent disability pension.
Form IN/CZ 1 (PDF 406.31 kB) for old age pension and disability pension or FORM IN/CZ 2 (PDF 838.74 kB) for the survival pension. These forms are used when the applicant or deceased was a member of the Indian Provident Fund. Form IN/CZ 3 (PDF 459.06 kB) This form is used as an Application for Indian Serbian Benefit under the Workers` Pension Plan (1995) if the applicant is under 50 years of age and no longer works in India. Form IN /CZ 5 (PDF 412.32 kB) This form is used as an application for Indian insurance benefit per survivor if the insured has died on the job.