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Get the free PRIVACY ACT STATEMENT: Your response to this request is voluntary; however, failure ...

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Form Approved OMB No. 09600395Social Security AdministrationMODIFIED BENEFIT FORMULA QUESTIONNAIRE NAME OF WAGE EARNER OR REEMPLOYED PROSOCIAL SECURITY NUMBER//NAME OF PERSON MAKING STATEMENT (if
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The Privacy Act Statement is a legal document that informs individuals about how their personal information will be collected, used, and protected.
Any organization or agency that collects, maintains, or uses personal information about individuals is required to file a Privacy Act Statement.
To fill out a Privacy Act Statement, organizations must provide detailed information about the purpose for collecting personal information, the types of information collected, and how the information will be used and protected.
The purpose of the Privacy Act Statement is to ensure that individuals are aware of how their personal information is being handled and to protect their privacy rights.
The Privacy Act Statement must include information about the purpose for collecting personal information, the types of information collected, how the information will be used, and how it will be protected.
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