Certification of Elections for Reduced Spouse's Benefits

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(q) and 205(a) 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 decision on your benefits.
We will use the information you provide to determine eligibility for benefits. We may also share
your information for the following purposes, called routine uses:
•

To Federal, State, or local agencies (or agents on their benefits behalf) for the purpose of
validating Social Security numbers used in administering cash or non– cash income
maintenance programs or health maintenance programs (including programs under the
Social Security Act); and,

•

To contractors and other Federal agencies, as necessary, for the purpose of assisting the
Social Security Administration in the efficient administration of its programs.

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
(SORN) 60-0058, entitled Master Files of Social Security Numbers (SSN) Holders and SSN
Applications, as published in the Federal Register (FR) on December 29, 2010, at 75 FR 82121;
60-0059, entitled Earnings Records and Self-Employment Income, as published in the FR on
January 11, 2006, at 71 FR 1819; 60-0089, entitled Claims Folders Systems, as published in the
FR on April 1, 2003, at 68 FR 15784; and 60-0090, entitled Master Beneficiary Record, as
published in the FR on January 11, 2006, at 71 FR 1826 Additional information and a full listing
of all our SORNs are available on our website at https://www.ssa.gov/privacy.