Revised PA & PRA Statements

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 808 and 1147 of the Social Security Act, as amended, allow us to collect this
information. Furnishing this information is voluntary. However, failing to provide all or part of
the information may affect your benefits.
We will use the information to make a determination on your overpayment waiver request or
change your monthly repayment rate. We may also share your information for the following
purposes, called routine uses:
•

To representative payees, when the information pertains to individuals for whom they
serve as representative payees, for the purpose of assisting the Social Security
Administration (SSA) in administering its representative payment responsibilities under
the Act and assisting the representative payees in performing their duties as payees,
including receiving and accounting for benefits for individuals for whom they serve as
payees; and

•

To third party contacts (including private collection agencies under contract with SSA)
for the purpose of their assisting SSA in recovering overpayments.

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
(SORN) 60-0103, entitled Supplemental Security Income Record and Special Veterans Benefits,
as published in the Federal Register (FR) on January 11, 2006, at 71 FR 1830, and 60-0273,
entitled Social Security Title VIII Special Veterans Benefits Claims Development and
Management Information System, as published in the FR on March 14, 2000, at 65 FR 13803.
Additional information, and a full listing of all of our SORNs, is available on our website at
www.ssa.gov/privacy.

SSA will insert the following revised PRA Statement into the form as soon
as possible:
Paperwork Reduction Act Statement - This information collection meets the
requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office
of Management and Budget (OMB) control number. We estimate that it will take about
120 minutes to read the instructions, gather the facts, and answer the questions. Send
only comments relating to our time estimate above to: SSA, 6401 Security Blvd,
Baltimore, MD 21235-6401.