Privacy Act Statement
Appointed Representative
Electronic Records Express
Collection and Use of Personal Information

Sections 205(a) [42 U.S.C. § 405], 223(d) [42 U.S.C. § 423], and 1631(e)(1)[42 U.S.C. § 1383] of the Social Security Act, as amended, authorize us to collect this information. We will use the information you provide to make a decision on the named claimant’s claim.


Providing this information is voluntary. However, failing to provide the requested information could prevent us from making an accurate and timely decision on the named claimant’s claim.


We rarely use the information you provide for any purpose other than to make a decision on a claimant’s claim. We may also disclose information to another person or to another agency in accordance with approved routine uses, which include but are not limited to the following:



  1. To enable a third party or an agency to assist us in establishing rights to Social Security benefits and/or coverage;
  2. To comply with Federal laws requiring the release of information from our records (e.g., to the General Services Administration and National Archives Records Administration);
  3. To make determinations for eligibility in similar health and income maintenance programs at the Federal, State, and local level; and
  4. To facilitate statistical research, audit, or investigative activities necessary to ensure the integrity of Social Security programs.

We may also use the information you provide in computer matching programs. Matching programs compare our records with records kept by other Federal, State, or local government agencies. Information from these matching programs can be used to establish or verify a person’s eligibility for federally-funded or administered benefit programs and for repayment of payments or delinquent debts under these programs.


A complete list of routine uses for this information is available in our Privacy Act Systems of Records Notices entitled, Claims Folder System (60-0089) and Electronic Disability (60-0320). These notices, additional information about this collection, and any other information regarding our systems and programs, are available on-line at www.socialsecurity.gov or at your local Social Security office.