Document
SSA-120 Internet Version Application for access to SSA Systems
ICR 202607-0960-003 · OMB 0960-0791 · Object 170768900.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | SSA-120 Internet Version Application for access to SSA Systems |
| Author | Scullark, Tyeebna OGC |
| Last Modified By | Writer |
| File Modified | 2026-07-24 |
| File Created | 2026-08-01 |
| Conversion State | complete |
Extracted Text
SSA will insert the following revised Privacy Act Statement as soon as possible: Privacy Act Statement Collection and Use of Personal Information Section 205(a) of the Social Security Act, as amended, 5 U.S.C. § 552a(e)(10), and 44 U.S.C. § 3553 allow us to collect this information, which we will use to authorize access to the agency’s information technology systems. Providing this information is voluntary, but not providing all or part of the information may affect your ability to access the agency’s information technology systems and resources. 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 Notices 60-0214 and 60-0361, 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.