POMS Reference

GN 03360: Privacy Act Administration, Communication and Other Procedures

TN 1 (09-91)

Exhibit 1 - SSA-1723-U4 - Requisition and Receipt for Technical Materials and Instructions (See GN 03360.040.E.)

Exhibit 2 - SSA-1841 - Certification of True Copy (See GN 03360.025.F.)

Exhibit 3 - SSA-1841 A - Certification of True Copy - File Box Copy (See GN 03360.025.F.)

Exhibit 4 - SSA-3179 - Freedom of Information Request (See GN 03360.045)

Exhibit 5 - SSA-3157 - Social Security Administration Facts About Computer Matching Programs (See GN 03360.015)

Exhibit 6 - SSA-5000 - Collection and Use of Information by the Social Security Administration (See GN 03360.015)

Exhibit 7 - SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (8-94) (See GN 03360.050.A.2.)

Exhibit 1 - SSA-1723-U4 (Requisition and Receipt for Technical Materials and Instructions)

G-SSA-1723-U4

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Exhibit 2 - SSA-1841 - Certification of True Copy

G-SSA-1841

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Exhibit 3 - SSA-1841 A - Certification of True Copy - File Box Copy

G-SSA-1841-A

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Exhibit 4 - SSA-3179 - Freedom of Information Request - Front

G-SSA-3179-1

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Exhibit 4 - SSA-3179 - Freedom of Information Request - Back

G-SSA-3179-2

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Exhibit 5 SSA-3157 - Social Security Administration Facts About Computer Matching Programs

G-SSA-3157

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Exhibit 6 SSA-5000 - Collection and Use of Information by the Social Security Administration

To view the form, go to SSA-5000.

Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 1)

G-SSA-4641-U2-1

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Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 2)

G-SSA-4641-U2-2

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Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 3)

G-SSA-4641-U2-3

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Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 4)

G-SSA-4641-U2-4

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