SSA will insert the following revised Privacy Act Statement into the form as soon as possible:
Privacy Act
Statement
Collection and Use of Personal Information
Sections 203 and 205 of the Social Security Act, as amended, allow us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent an accurate and timely decision on any claim filed.
We will use the information to make a determination of eligibility for benefits. We may also share your information for the following purposes, called routine uses:
To the Social Security agency of a foreign country, to carry out the purpose of an international Social Security agreement entered into between the United States and the other country, pursuant to section 233 of the Social Security Act.
To the Department of State and its agents for administering the Act in foreign countries through facilities and services of that organization.
In addition, we may share this information in accordance with the Privacy Act and other federal laws. For example, where authorized, we may use and disclose this information in computer matching programs, in which our records are compared with other records to establish or verify a person’s eligibility for federal benefit programs and for repayment of incorrect or delinquent debts under these programs.
A
list of additional routine uses is available in our Privacy Act
System of Records Notices (SORNs) 60-0059, entitled Earnings
Recording and Self-Employment Income System, and 60-0089, entitled
Claims Folders Systems. Additional information and a full listing of
all our SORNs are available on our website at
www.socialsecurity.gov/foia/bluebook.
| File Type | application/msword |
| Author | 889123 |
| Last Modified By | Mandley, Tasha |
| File Modified | 2017-03-15 |
| File Created | 2017-03-15 |