SSA-159 Government to Government Services Online Website Registr

Form SSA-159 (07-2017)
Discontinue Prior Editions
Social Security Administration

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OMB No: 0960-0757

GSO Website Registration Form
Complete the following information to obtain access to GSO services. SSA sponsors should email the completed form to
[email protected]. Each new user will receive an email containing the user name, and a phone call to provide
the password.
Please tab from field to field.

GSO USER - CONTACT INFORMATION
Name:

Street
Address:

Organization
Name:

City:

Organization ID or RID:

Zip Code:

Phone
(include area code):

Email
Address:

State:

For SSA internal users only:
Select user type:

Individual User(s)

Organizational Shared Account

SELECT UTILITIES THE NEW USER WILL NEED TO ACCESS
B - Birth

BL - Black Lung

DE - Data Exchange

D - Death

FF - Fugitive Felon

PR - Prisons

DDE - Totalization Death Data Exchange

OCSE - OCSE Reporting

SM - Secure Messaging

IAR - Interim Assistance Reimbursement

SW - Sheltered Workshop

Other - Specify Utility in Sponsor Comments
SSA SPONSOR VERIFICATION (FOR COMPLETION BY SPONSORS ONLY):
Sponsor Name:
Sponsor Organization (Office/Division/Branch):
Phone (include area code):

Sponsor Email Address:

Sponsor Comments:
FOR DATA EXCHANGE SHELTERED WORKSHOP, AND SECURE MESSAGING ONLY:
List all trading partners with whom the user will exchange data. For UIT use only.
Name

User ID

Organization/State

Form SSA-159 (07-2017)

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Privacy Act Statement
Collection and Use of Personal Information

We are removing the PA
Statement per OGC

Section 205(a), of the Social Security Act, as amended, 5 U.S.C. 552a(e)(10), and the Government
Paperwork Elimination Act, authorize us to collect this information. We will use the information you provide
to determine eligibility to access Government Services Online (GSO).
The information you furnish on this form is voluntary. However, failure to provide the requested information
may prevent us from granting access to GSO.
We rarely use the information you supply for any purpose other than for determining eligibility for access.
However, we may use it for the administration and integrity of Social Security programs. We may also
disclose information to another person or to another agency in accordance with approved routine uses,
which include but are not limited to the following:
1. To comply with Federal laws requiring the release of information from Social Security records
(e.g., to the Government Accountability Office and Department of Veterans Affairs);
2. To facilitate investigative and audit activities necessary to assure the integrity of Social Security
programs.
We may also use the information you provide in computer matching programs. Matching programs compare
our records with records kept by other Federal, State, or local government agencies. Information from these
matching programs can be used to establish or verify a person's eligibility for Federally-funded or
administered benefit programs and for repayment of payments or delinquent debts under these programs.
Additional information regarding this form, routine uses of information, and our programs and systems, is
available on-line at www.socialsecurity.gov or at your local Social Security office.
Paperwork Reduction Act Statement - This information collection meets the requirements of
44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to
answer these questions unless we display a valid Office of Management and Budget control number. We
estimate that it will take about 15 minutes to read the instructions, gather the facts, and answer the
questions. Send only comments relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore,
MD 21235-6401.