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FSA-2007
Date of Modification 12-31-2007
STATEMENT REQUIRED BY THE
PRIVACY ACT
FOR
NON-APPLICANTS
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INSTRUCTIONS FOR PREPARATION
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Purpose:
This
form is used to solicit the information it deems necessary to
support an FSA application by a party other than the applicant.
This form is used to advise a non-applicant party that the
collection of information is voluntary, and that failure to
provide necessary information may delay processing or cause the
rejection of the application. It also addresses disclosure of
collected information by FSA.
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Handbook
Reference:
3-FLP
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Number
of Copies:
Original
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Signatures
Required:
Original
signed by Non-Applicant party.
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Distribution
of Copies:
Original
in case file.
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Automation-Related
Transactions: (Instructions for writers: provide only the
information required, i.e. ADPS TC 3K. If no automation
actions are required, insert N/A) N/A
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Contact
State Office if additional guidance is needed.
File Type | application/msword |
File Title | Template Users: Select the text for each of the instruction components below and type over it without changing the font type, |
Author | Preferred Customer |
Last Modified By | maryann.ball |
File Modified | 2012-05-17 |
File Created | 2012-05-17 |