Application. International posting

Transcription

1 International posting Application A1 certificate concerning applicable social insurance legislation/ Certificate of coverage for self-employed persons and directors/major shareholders (DGA) Use this form to apply for a certificate which shows that you are covered by social insurance legislation in the Netherlands while working outside the Netherlands. 1 Details of self-employed person/dga If you receive your SVB correspondence electronically, the certificate will always be sent to your message box (Berichtenbox). burgerservicenummer surname and gender male female prefixes (in full) first forename and initials family name at birth prefixes date of birth What is your nationality? Residential address of self-employed person The residential address is your official address (this is generally your family s home address) You can tick more than one box if appropriate Dutch other nationality, namely: telephone number address Postal address Only complete this section if you do not want the SVB to send correspondence to your home address. next

2 Application for A1/certificate of coverage (self-employment) 2 van 9 2 Company details business name PO Box of PO Box Please enclose the following documents l ast year s statement of investments. If you do not have such a statement, enclose your annual balance sheet. turnover tax return and turnover tax assessment for the previous quarter most recent signed order confirmation(s) or signed contract(s) 3 Your situation If you work in one or more EU Member States, it is necessary to know how often you work outside the Netherlands and how often within the Netherlands in order to determine whether you can continue to be covered by Dutch social insurance. When will you start working outside the Netherlands? If this is not yet known, indicate for what period you wish to apply for the certificate. from to Will one or more of the following situations apply during that period? Tick as applicable. You can tick more than one box if appropriate. I will also be working in paid employment in another, namely as from Registration number or identification number I will also be working as a civil servant in another, namely as from Registration number or identification number I will also have an enterprise in another, namely as from Registration number or identification number

3 Application for A1/certificate of coverage (self-employment) 3 of 9 I will also receive a benefit from another, namely as from * Registration number or identification number * Only tick this if you receive a statutory benefit for sickness, unemployment, invalidity or retirement from a other than the Netherlands, specifically, an EU Member State, Norway, Iceland, Liechtenstein or Switzerland. If you receive such benefits, you may be treated as employed in that. none of the above situations apply to me Which situation applies to you? member of cockpit or cabin crew in aviation, home base seafarer or dredger (You have a seaman s book, and the seagoing vessel where the work is to be carried out is listed in the register of seagoing vessels.) Under what flag is this vessel sailing name of vessel registration number of vessel rhine boatman (Enclose a copy of a Rhine navigation certificate.) name of the vessel s operator In what is the vessel s operator based? If there are any other operators, are any of them based outside the Netherlands no yes name of vessel registration number of vessel share fisherman Under what flag is this vessel sailing name of vessel registration number of vessel

4 Application for A1/certificate of coverage (self-employment) 4 of 9 Service or maintenance mechanic or international transport worker (land or waterway transport) in the following countries (up to 10 per application) other Will you continue to work in the Netherlands as well? Only answer this question if you ticked Service or maintenance mechanic or other in the previous question. yes, for more than 25% of my total working time yes, for less than 25% of my total working time and more than one day In which does the centre of your interests lie? Are you a director/major shareholder (DGA) yes no What type of work do you do in the Netherlands? From what date have you been working as a self-employed person/dga in the Netherlands What was your most recent date of work in the Netherlands as a selfemployed person/dga? What was your most recent place of work? name of client address of client no, or in any case for less than one day a month

5 Application for A1/certificate of coverage (self-employment) 5 of 9 What type of work will you do outside the Netherlands? Will the infrastructure of your enterprise in the Netherlands necessary for business continuation after your return to the Netherlands remain unchanged during your work abroad? Tick as applicable and enter the requested details See the explanatory notes for information on infrastructure yes no Fill in the name of the company where you will be working. For example, this may also be the name of a project, client or tour. It is important that you give information on the location(s) in as much detail as possible. If, during a check outside the Netherlands, it turns out that you gave incomplete or incorrect addresses, this may have negative consequences for you. I will be working at one location name of company I will be working at various locations You can name up to 10 exact locations per application (If working in different countries, please give a location for each ) location 1 name of company location 2 name of company

6 Application for A1/certificate of coverage (self-employment) 6 of 9 location 3 name of company Please give details for locations 4 to 10 on a separate sheet. 4 Family members See information leaflet. Only complete this section if you are going to work in Israel. Will any of your family members join you? no yes Family member 1 family name at birth and initials date of birth burgerservicenummer nationality gender male female If you will be joined by more than 1 family member, provide their details on a separate sheet. 5 Enclosures I am enclosing the following document(s): last year s statement of investments or annual balance sheet turnover tax return and turnover tax assessment for the previous quarter most recent signed order confirmation(s) or signed contract(s) authorisation form other documents, namely 6 Signature date signature of applicant self-employed person/representative I declare that the information I have provided is true and complete. If you are a representative, you must attach one authorisation, signed by the self-employed person. Send this form and any attachments to: SVB, Postbus 18607, 3501 CR Utrecht, the Netherlands. If you have any questions, please call telephone number (020)

7 Explanatory notes Explanatory notes Entitlement to child benefit If you receive child benefit, it is important that you send the SVB office serving your area a copy of the A1/Certificate of Coverage. Dutch Health Insurance Act (Zvw) If you are insured under the Zvw scheme, you should submit a request for a European health insurance card to their health insurance company. You can use this card to claim health care outside the Netherlands. In what countries is an A1/Certificate of Coverage valid? A1 certificates/certificates of coverage can only be issued for work in EU/EEA countries and countries with which the Netherlands has concluded an agreement on social security. Certificates for self-employed persons and directors who are also major shareholders (DGA) can only be issued if they are covered by the agreement. For this reason, it is not possible to apply for a posting certificate if you are going to work as a self-employed person or as a director and major shareholder (DGA) in one of the following countries: Australia, Bosnia Herzegovina, Canada, Cape Verde, Egypt, India, Kosovo, Macedonia, Morocco, Montenegro, New Zealand, Serbia, Tunisia or Uruguay. If you are going to work temporarily as a self-employed person, or as a director and major shareholder (DGA) in any of the countries listed below, it is possible to apply for an A1 certificate/certificate of coverage for: Austria, Belgium, Bulgaria, Canada: Quebec *, Chile *,Channel Islands *, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Isle of Man *, Israel, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, South Korea *, Spain, Sweden, Switzerland, United Kingdom, United States of America *. ( * : only if you perform activities both in the Netherlands and in the treaty ) Authorisation (see sections 5 and 6) If you have a representative who acts on your behalf (for instance a tax consultant or accountant), please attach an authorisation with your first request. You can phone us to ask for an authorisation form. Please note that all correspondence will then be sent to the representative when you authorise someone to act for you. next

8 Application 8 of 9 Qualifying conditions Immediately prior to starting your work abroad, you worked as a selfemployed person in the Netherlands for at least 2 months. A substantial part of your activities is normally carried out in the Netherlands. If less than 25%, this is an indication that you do not normally carry out a substantial part of your activities in the Netherlands. The infrastructure which is necessary to continue your work as a selfemployed person on your return must remain intact. Examples of this include: using or acquiring your own office space payment of social insurance contributions and taxes having a BTW (VAT) number and/or registration with the Chamber of Commerce buying work equipment and office supplies (PC, telephone, furniture) stocking up products for your business producing or ordering business stationery, business cards, and such creating business advertising Your activities in the Netherlands and abroad must be of a similar nature. For example, if a self-employed carpenter takes on a job involving temporary work as a self-employed teacher in another EU Member State, this does not qualify as activities of a similar nature. The work activities outside the Netherlands are of limited duration (for most of the countries listed above, the maximum period is 24 months). Centre of your interest If you work in one or more EU Member States and you do not carry out a substantial part of your activities in your of residence, it is necessary to know in what the centre of your company s interests or your activities as a self-employed person lies. The following aspects are considered: the fixed and permanent place from which you carry out your work; the usual nature or duration of the activities pursued; the number of services rendered; your intention. To qualify for an A1 certificate confirming that you will continue to be covered by compulsory national insurance in the Netherlands, the centre of your interest must be in the Netherlands. Different procedure for employees living outside the Netherlands If you live outside the Netherlands and you carry out work in two or more EU Member States (including the Netherlands) from time to time, you need to apply for a decision from the competent institution in your of residence, which states that you continue to be covered by Dutch social insurance.

9 Application 9 of 9 Family members Co-insured family members Under Dutch legislation, family members who move with a self-employed person to Israel are regarded as continuing to live in the Netherlands for a period of up to five years. This means that they will remain covered by Dutch national insurance unless they take up work activities of their own in the of destination. If more than 3 family members are moving with you, enclose their details on a separate sheet. Family members who are not co-insured Family members who move with you to a other than Israel will no longer be covered by the Dutch national insurance schemes. However, it will be possible for them to take out voluntary insurance under the AOW pension scheme and/or the Anw survivor benefit scheme. You can find more information about this at Signature Incorrect details in the application form can result in cancellation of the certificates issued and application of non-dutch social insurance legislation, even with retroactive effect. The SVB is authorised to carry out the necessary checks before, during and after your period of work outside the Netherlands to see whether the qualifying conditions for a certificate are or have been met. If a check shows that you have not paid social insurance contributions in the Netherlands for the period shown on the certificate, the SVB may decide to cancel the certificate and to declare you to be covered under the legislation of another.