Internet-Based Static or Dynamic Webform (through Upload Documents or CPAS)

Privacy Act Statement
Collection of and Use of Personal Information
Section 205(a) of the Social Security Act, as amended, and Executive Order 14058, allow us to
collect your information, which we will use to process the forms and/or evidence submitted.
Providing your 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, our contractors, and others, as
outlined in the routine uses within System of Records Notices 60-0089, 60-0320, and 60-0373,
available at www.ssa.gov/privacy. The information you submit may also be used in computer
matching programs for Federal benefits eligibility and to recoup debts under these programs.