Privacy Act Statement for SF 1055

PRIVACY ACT NOTICE SF 1055.docx

Claims Against the U.S. for Amounts Due in Case of a Deceased Creditor

Privacy Act Statement for SF 1055

OMB: 1530-0004

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PRIVACY ACT NOTICE


Collection of the information in this Claim form is authorized by 5 U.S.C. § 552a. This information will be disclosed to the Department of the Treasury and its fiscal and financial agents, and other federal agencies, as necessary to process your claim. This information may also be disclosed to a court, congressional committee or another government agency as authorized or required to verify your receipt of federal payments. Although providing the requested information is voluntary, your claim cannot be processed without it.




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJohn Wesley Powe III
File Modified0000-00-00
File Created2021-01-27

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