EVS One-Time Registration

EVS Federal Privacy Act Statement
Individual Employers
EIN: __ __- __ __ __ __ __ __ __

I understand that the Social Security Administration will verify Social Security
Numbers (SSNs) solely to ensure that the records of my employees are correct for
the purpose of my completing Internal Revenue Service Forms W-2 (Wage and
Tax Statement).
I also understand that any information which I receive from records maintained
by the Social Security Administration is governed by 5 USC 552a(I) of the
Federal Privacy Act. Under this Act, anyone who obtains this information under
false pretenses, or uses it for a purpose other than that for which it was requested,
may be punished by a fine or imprisonment or both.
Further, EVS information does not imply that you or your employee intentionally
provided incorrect information about the employee's name or SSN. It is not a
basis, in and of itself, for you to take any adverse action against the employee.
EVS should only be used to verify workers currently employed or an entire
payroll database. Company policy concerning the use of EVS should be applied
consistently to all workers, e.g., if used for new hires, verify all new hires; if used
to verify your database, verify the entire database. Any employer that uses the
information SSA provides regarding name/SSN verification as a pretext for taking
adverse action against an employee may violate state or federal law and be subject
to legal consequences.

Signature _______________________________ Date______________________
Name (Printed) __________________________ Title______________________