Activation Notice for BSO Use (for both IRES and CSA)

Employer Notice Sample(s)

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Social Security Administration

Retirement, Survivors and Disability Insurance

Important Information

Office of Central Operations

P.O. Box 33006

Baltimore, Maryland 21290-3006

Date: September 12, 2005

EIN: XX-XXXXXXX

DISNEY WORLD INDUSTRIES

12 WALT DISNEY WAY

ORLANDO, FL 12345-6789

On September 12, 2001, MICKEY MOUSE, 100 MICKEY MOUSE ST, ORLANDO, FL, (xxx) xxx-xxxx requested access to use the Social Security Administration’s (SSA’s) Business Services Online as an authorized representative of DISNEY WORLD INDUSTRIES.

The following pages will describe the services to which your employee has requested access and will provide instructions on what actions you must take. Failure to follow the enclosed instructions may result in your employee not being granted access to the requested services.

Things to Remember

• If your employee has requested access to multiple services, you must approve or deny each one individually.

• If you do not approve of your employee’s requests, you should inform your employee that you have received this letter and have denied the request. This will help prevent you from receiving future requests for services from the Social Security Administration (SSA).

• If your employee requests access to any other services that BSO provides, you will receive additional letters from the Social Security Administration explaining the services requested and the actions you must take.

• Notify us if your employee leaves your company or if you choose to revoke any or all of your employee’s authorization to use SSA’s Business Services Online.

• If SSA determines or suspects there has been misuse of the services, SSA may ban you and/or the company you represent from the use of these services.

For a complete listing of Business Services available online, please go to www.socialsecurity.gov/bso/services.htm.

Under the Privacy Act of 1974 (5 U.S.C. 552a), anyone who knowingly and willingly requests or obtains an individual’s record from a Federal agency under false pretenses or uses it for a purpose other than that for which it was requested shall be subject to a criminal penalty.

If You Have Any Questions

If you have any questions, please call us at 1-800-772-6270 between 7:00 a.m. and 7:00 p.m. Eastern time, Monday through Friday. We can answer most of your questions over the phone. When you call, please have this letter with you; it will help us answer your questions. You can also e-mail your questions to [email protected] or write us at the address shown on the first page of this letter.

Carolyn L. Simmons

Associate Commissioner for Central Operations

See Next Page

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99-9999999 Page x of X

Your employee, MICKEY MOUSE, has requested access to “Social Security Number Verification Service”

Using “Social Security Number Verification Service,” your employee can:

• Verify the names and Social Security numbers of current or former employees to ensure accurate wage reporting

Employer action:

In order for your employee to gain access to “Social Security Number Verification Service,” you must approve the request. To do so, simply give your employee the activation code below. The activation code will enable your employee to start using “Social Security Number Verification Service”, as an authorized representative of your company.

Before approving this request, be sure to read the proper use of “Social Security Number Verification Service” located at www.socialsecurity.gov/bso/services.htm. You may be held liable if your employee misuses this service.

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This activation code will expire 45 days from the date it was requested.

If you do not approve of this request, destroy the activation code and inform your employee that you have denied the request to access “Social Security Number Verification Service.” Otherwise, your employee may assume you never received this letter and request that the Social Security Administration (SSA) to send you another one.