SSA-8240 (Paper Version)

Authorization for the Social Security Administration to Obtain Wage and Employment Information from Payroll Data Providers

PA Statement 0960-0807 (Revised)

SSA-8240 (Paper Version)

OMB: 0960-0807

Document [docx]
Download: docx | pdf

Privacy Act Statement
Collection and Use of Personal Information

Sections 205(a), 225(c), and 1631(e) of the Social Security Act, as amended, allow us to collect your information or the information you are submitting on behalf of another, which we will use to obtain wage and employment information from payroll data providers and to administer the Social Security Act. Providing the information is voluntary, but not providing all or part of the information may prevent an accurate and timely decision regarding Social Security benefits and payments. As law permits, we may use and share the information you submit, including with employers, contractors, other Federal agencies, and others, as outlined in the routine uses within System of Records Notice (SORN) 60-0089, available at www.ssa.gov/privacy. The information you submit may also be used in computer matching programs to establish or verify eligibility for Federal benefit programs and to recoup debts under these programs.











File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorScullark, Tyeebna OGC
File Modified0000-00-00
File Created2023-10-07

© 2024 OMB.report | Privacy Policy