SSA-632 - Request for Waiver of Overpayment Recovery

Request for Waiver of Overpayment Recovery or Change in Repayment Rate

Revised Privacy Act Statement for SSA-632-BK (0960-0037)

SSA-632 - Request for Waiver of Overpayment Recovery

OMB: 0960-0037

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Privacy Act Statement
Collection and Use of Personal Information

Sections 204 and 1631 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 make a waiver determination on an overpayment and to obtain authorization for financial account information. Providing this information is voluntary, but not providing all or part of the information may prevent us from assisting you with the request. As law permits, we may use and share the information you submit, including with other Federal agencies, employers, third party contacts, and others as outlined in the routine uses within System of Records Notices (SORN) 60-0094, 60-0103, and 60-0320, 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 Created2023-12-11

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