Employee Identification Statement

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
Section 205(c)(2)(A) of the Social Security Act, as amended, allows us to collect this
information. Furnishing us this information is voluntary. However, failing to provide all or part
of the information may prevent us from determining the beneficiary’s eligibility for Social
Security benefits.
We will use the information to ensure the beneficiary’s wage record is accurate and to make a
correct determination of eligibility for Social Security benefits. We may also share the
information for the following purposes, called routine uses:
1. To student volunteers, individuals working under a personal services contract, and other
workers who technically do not have the status of Federal employees, when they are
performing work for the Social Security Administration (SSA), as authorized by law, and
they need access to personally identifiable information in SSA records in order to
perform their assigned Agency functions.
2. To contractors and other Federal agencies, as necessary, for the purpose of, assisting the
Social Security Administration (SSA) in the efficient administration of its programs.
In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notices
(SORNs) 60-0059, entitled Earnings Recording and Self-Employment Income System and 600090, entitled Master Beneficiary Record. Additional information and a full listing of all our
SORNs are available on our website at www.socialsecurity.gov/foia/bluebook.

6/9/2017 8:31 PM