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 202(d), 202(h), and 216(e) 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 us from making an accurate and timely decision in determining the child applicant’s eligibility for benefits.
We will use the information to make a determination for eligibility of benefits. We may also share your information for the following purposes, called routine uses:
To third party contacts in
situations where the party to be contacted has, or is expected to
have, information relating to the individual’s capability to
manage affairs or eligibility for or entitlement to benefits under
the Social Security program when the data is needed to establish the
validity of evidence or to verify the accuracy of information
presented by the individual, and it concerns the individual’s
eligibility for benefits under the Social Security program; and
To Federal, State, or local agencies (or agents on their behalf) for administering cash or non-cash income maintenance or health maintenance programs (including programs under the Act).
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 Notice (SORN) 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 | 2017-06-27 |
| File Created | 2017-06-27 |