SSA-L707 -- Private Sector

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 205(a) and 1631(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 an accurate and timely decision on any claim filed.
We will use the information to make a determination of eligibility for Social Security or
Supplemental Security Income benefits. We may also share your information for the following
purposes, called routine uses:
•

To third party contacts where necessary to establish or verify information provided by
representative payees or payee applicants;

•

To specified business and other community members and Federal, State, and local
agencies for verification of eligibility for benefits; 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) 60-0089, entitled Claims Folders System, as published in the Federal Register (FR) on
April 1, 2003, at 68 FR 15784; 60-0090, entitled Master Beneficiary Record, as published in the
FR on January 11, 2006, at 71 FR 1826; and 60-0103, entitled Supplemental Security Income
Record and Special Veterans Benefits, as published in the FR on January 11, 2006, at 71 FR
1830. Additional information, and a full listing of all of our SORNs, is available on our website
at www.ssa.gov/privacy.