SSA-6230 Representative Payee Report (Child)

See Revised Privacy Act Attached

See Revised PRA Attached

SSA will insert the following revised Privacy Act and PRA Statements into the form at
its next scheduled reprinting:
PRIVACY ACT STATEMENT
Collection and Use of Personal Information
Sections 205(j) and 1631(a) of the Social Security Act, as amended, authorize us to
collect the information on this form. The information you provided enables us to account
for the child(ren)’s payments and to ensure that you use the payments for the child(ren)’s
needs.
Your responses are voluntary. However, without the information, we may not be able to
continue sending the child(ren)’s payments to you.
We rarely use the information you give us for any purpose other than for accounting
purposes. However, we may use it for the administration and integrity of Social Security
programs. We may also disclose information to another person or to another agency in
accordance with approved routine uses, which include, but are not limited to, the
following:
1. To comply with Federal laws requiring the release of information from Social
Security records (e.g. to the Government Accountability Office and Department
of Veterans Affairs);
2. To facilitate statistical research, audit , or investigative activities necessary to
assure the integrity and improvement of Social Security programs;
3. To respond to a request on your behalf from a Congressional office or the Office
of the President; and
4. To other Federal agencies and our contractors, including external data sources, to
assist us in efficiently administering our programs.
We may also use the information you give us in computer matching programs. Matching
programs compare our records with records kept by other Federal, State, or local
government agencies. We use the information from these programs to establish or verify
a person’s eligibility for federally funded or administered benefit programs and for
repayment of incorrect payments or delinquent debts under these programs.
A complete list of routine uses for this information is available in our Privacy Act System
of Records Notice (SORN) entitled, Master Representative Payee File (60-0222). The
complete SORN, additional information about this form, routine uses of information, and
our programs and systems are available online at www.socialsecurity.gov or your local
Social Security office.

Paperwork Reduction Act Statement - This information collection meets the
requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office
of Management and Budget control number. We estimate that it will take about 15
minutes to read the instructions, gather the facts, and answer the questions. You may send
comments on our time estimate above to: SSA, 6401 Security Blvd, Baltimore,
MD 21235-6401. Send only comments relating to our time estimate to this address, not
the completed form.