POMS Reference

GN 03360: Privacy Act Administration, Communication and Other Procedures

TN 4 (08-94)

A. Policy

Besides governing the use and disclosure of personal information, the Privacy Act requires SSA to inform individuals of their rights when collecting information from them. The information which must be included is summarized in GN 03301.020B.3.

This information is printed on most of SSA's applications and forms. You must ensure that individuals are aware of their rights in situations where the data collection form does not include this information.

B. Procedure

1. Use of Form SSA-5000

  1. Use Form SSA-5000 (Collection and Use of Information by the Social Security Administration) to inform an individual of the information required by the PA whenever the data collection form or application does not contain it. See GN 03360.999, Exhibit 6.

  2. When requesting personal information by telephone, give an individual an oral summary of the SSA-5000 and follow up by mailing it to him or her if:

    • no notice has been given prior to the telephone contact, and

    • more than 3 months have elapsed since a notice was given, or it is impossible to tell when the last notice was given.

  3. Do not give the SSA-5000 to employees or other third parties who are not disclosing information about themselves.

2. Use of Form SSA-3157

Information about computer matching has been added to the existing Privacy Act Notice on most forms used to collect information from the public. However, if you are collecting information using a form which does not explain com puter matching, give Form SSA-3157 (Facts About Computer Matching) to the individual. See GN 03360.999, Exhibit 5.