Certification of Elections for Reduced Spouse's Benefits

Certification of Elections for Reduced Spouse's Benefits

Privacy Act Statement 0398 (revised)

Certification of Elections for Reduced Spouse's Benefits

OMB: 0960-0398

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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

Section 202(q)(5)(A) of the Social Security Act, as amended, allows us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent a timely and accurate decision on your eligibility for spousal benefits.


We will use the information you provide to determine benefits eligibility. We may also share the information for the following purposes, called routine uses:


  • To applicants or claimants, prospective applicants or claimants (other than the data subject), their authorized representatives or representative payees to the extent necessary to pursue Social Security claims, and to representative payees, when the information pertains to individuals for whom they serve as representative payees, for the purpose of assisting the Social Security Administration (SSA) in administering its representative payment responsibilities under the Act and assisting the representative payees in performing their duties as payees, including receiving and accounting for benefits for individuals for whom they serve as payees; and


  • To third party contacts that may have information relevant to SSA's establishment or verification of information provided by representative payees or payee applicants.


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 October 31, 2019, at 84 FR 58422, and SORN 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 of our SORNs, is available on our website at www.ssa.gov/privacy.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorOlean, Charles
File Modified0000-00-00
File Created2021-09-13

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