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SSA-8510 – Title II and Title XVI general evidence (Upload documents)
ICR 202606-0960-007 · OMB 0960-0801 · Object 170831500.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | SSA-8510 – Title II and Title XVI general evidence (Upload documents) |
| Author | Sasha Nsafoah |
| Last Modified By | Writer |
| File Modified | 2026-07-02 |
| File Created | 2026-08-01 |
| Conversion State | complete |
Extracted Text
SSA will insert the following 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, which we will use to request evidence, information, or proofs that may support the claimant’s benefit application or payment continuation. Providing this information is voluntary, but not providing all or part of the information may prevent an accurate and timely decision for Social Security benefits. As law permits, we may use and share the information you submit, including with other Federal agencies, contractors, and others, as outlined in the routine uses within System of Records Notice 60-0089, available at www.ssa.gov/privacy. The information you submit may also be used in computer matching programs for Federal benefits eligibility or to recoup debts under these programs.