Document
Non-Federal Employee Respondent
ICR 202607-0960-006 · OMB 0960-0792 · Object 171301000.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Non-Federal Employee Respondent |
| Author | Sasha Nsafoah |
| Last Modified By | Writer |
| File Modified | 2026-07-23 |
| File Created | 2026-08-01 |
| Conversion State | complete |
Extracted Text
SSA will insert the following revised Privacy Act Statement into the form as soon as possible: Privacy Act Statement Collection and Use of Personal Information Sections 3371-3375 of Title 5 of the U.S. Code allow us to collect this information, which we will use to document your Intergovernmental Personnel Act (IPA) assignment. Providing the information is voluntary, but not providing all or part of the information may result in your ineligibility to participate in the IPA Mobility Program. 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 OPM System of Records Notice (SORN) OPM/GOVT-1, available at www.opm.gov/privacy and SSA SORN 60-0239, 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.