0704-0100 Ssnj

0704-0100_DD2168_SSN Memo

Application for Discharge of Member or Survivor of Group Certified to Have Performed Active Duty with the Armed Forces of the United States

0704-0100 SSNJ

OMB: 0704-0100

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June 4, 2019

MEMORANDUM FOR THE ACTING PRINCIPAL DIRECTOR, MILITARY COMMUNITY AND

FAMILY POLICY

SUBJECT: Justification for the Continued Use of Social Security Numbers on DD Form 2168,

“Application for Discharge of Member of Group Certified to Have Performed Active Duty

with the Armed Forces of the United States” - Accepted

Thank you for completing a review of Social Security Number (SSN) use within this form. The

Defense Privacy, Civil Liberties and Transparency Division (DPCLTD) has reviewed this request and has

accepted your justification for the continued use of the SSN for the purpose of (13) Other Cases, to

determine if an individual was part of an established group that previously provided active duty military

equivalent service as a civilian or contractor and should be issued a DD Form 214 and DD Form 1300.

This form must be reviewed on a continuous basis and a new justification must be provided if any change

to the System of Records Notice is submitted.

SSN collection by the form in Question 18.b is not approved. There is no language in the

identified DoD Issuance, DoDD 1000.20, “Active Duty Service Determinations for Civilian or

Contractual Groups,” requiring the SSN to identify the applicant on the form.

The Privacy Act Statement on the form must be updated to include DoDD 1000.20. Please work

with the Department of Defense (DoD) Forms Management Office to update it and submit the approved

final form to this office by November 30, 2019.

While this form has been identified as requiring collection, maintenance, and use of the SSN, you

must ensure the data is afforded the highest protections practicable through use of appropriate

administrative, technical, and physical safeguards. Please maintain a copy of your justification and this

memorandum in your records.

SSN Justifications must be renewed three (3) years after the date of this memorandum if the

associated System of Records has not been updated.

If you have any questions, please contact Mr. Brent Bice at (703) 571-0075 or email,

brent.j.bice.civ@mail.mil.

Cindy L. Allard

Chief, Defense Privacy, Civil Liberties,

and Transparency Division

cc:

WHS/ESD/RPDD

WHS/ESD/DD (Forms)

OVERSIGHT AND

COMPLIANCE

ALLARD.CINDY

.L.1231656614

Digitally signed by

ALLARD.CINDY.L.1231656614

Date: 2019.06.04 08:03:29

-04'00'

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AuthorMicrosoft Office User
File Modified2019-06-04
File Created2019-06-04

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