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Acknowledgement for Online Services
OMB Number: 0960-0767
Expires: 09/30/2015

By entering this United States Government Website, I agree to the following terms and conditions:

  • I will not disclose any information or data about a claimant that I access on this website without the claimant's written, signed consent unless there is a Federal law or regulation authorizing me to disclose this information or data;
  • I will not knowingly furnish, or participate in furnishing, false or misleading information to the Social Security Administration;
  • I will not enter this website unless I have installed anti-virus software, anti-spyware software, and personal firewalls on my computer;
  • I will update my operating system, application software, and security software regularly to maintain the latest data protection;
  • I will not store User-IDs and passwords on my computer.

WARNING

  • If you improperly disclose any information or data that you access on this website or fail to take proper measures to protect that information or data from improper disclosure, and your actions result in an improper disclosure, you may be suspended for 1-5 years from representing anyone before the Social Security Administration, or you may be disqualified from representing anyone before the Social Security Administration for an indefinite period of time.
  • If you improperly disclose any information or data that you access on this website or fail to take proper measures to protect that information or data from improper disclosure, and your actions result in an improper disclosure, you may be found guilty of a felony and subject to a fine of not more than $10,000 or imprisonment of not more than 5 years, or both.
  • If you knowingly furnish, or participate in furnishing, false or misleading information to the Social Security Administration, you may be subject to civil and/or criminal prosecution.
  • Use of the Certified Electronic Folder may be monitored, recorded, and audited. We may disclose unauthorized or improper use to law enforcement personnel investigating or prosecuting a violation of civil or criminal law and to officials of domestic and foreign agencies.

Claimant's Social Security Number:

By providing the Claimant's Social Security Number to access his or her Electronic Folder and selecting the "I Agree" button, you certify that you have read, understand and agree to the above statements.


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