Form SSA-8552 Interview Confirmation

Form SSA-8552 (04-2018)
Discontinue Prior Editions
Social Security Administration

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OMB No. 0960-0189

PLEASE COMPLETE AND RETURN THIS FORM TO ME
Interview Confirmation
Claim Number: XXX-XX1.

I / We will be available for your interview as scheduled.
YES
NO
If NO, please phone me as soon as possible to schedule a more convenient time.

2.

My telephone number is: (

3.

My address is:

4.

Signature:
Date:

)

.

Form SSA-8552 (04-2018)

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Privacy Act Statement
Collection and Use of Personal Information
Sections 205(a), 228(a), 1614(a) and 1836 of the Social Security Act, as amended, allow us to
collect this information. Furnishing us this information is voluntary. However, failing to provide
all or part of this information may prevent us from verifying your eligibility for benefits.
We will use the information to check data for accuracy and to verify documentation used to
establish your eligibility for benefits. We may also share your information for the following
purposes, called routine uses:
1. To third party contacts in situations where the party to be contacted has, or is expected to
have, information relating to the individual's capability to manage their affairs or
eligibility for or entitlement to benefits under the Social Security program when the data
are needed to establish the validity of evidence or to verify the accuracy of information
presented by the individual; and
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. We
will disclose information under the routine use only in situations in which SSA may enter
into a contractual or similar agreement with a third party to assist in accomplishing an
agency function relating to this system of records.
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) 60-0040, entitled Quality Review System: and 60-0090, Master Beneficiary Record.
Additional information and a full listing of all our SORNs are available on our website at
https://www.socialsecurity.gov/foia/bluebook.