TN 12 (07-94)

A. Policy

The policy for disclosure of tax data follows,

1. Disclosure to Authorized Individual

You may disclose tax data to the following authorized individuals:

• The taxpayer (SI 02310.040 B.6);

• A person having material interest in the individual's taxes (e.g., legal guardian, natural or adoptive parents);

• An individual or organization specifically authorized in writing by the taxpayer to receive the information. (See C below regarding written authorization);

• In the case of a deceased taxpayer, the executor, administrator, or trustee of the taxpayer's estate; or

• The payer (as defined in SI 02310.040 B.3).

2. Disclosure to Taxpayer's Designee

Disclose tax data to a designee of the taxpayer only if the taxpayer specifically authorizes the disclosure in writing (See SI 02310.041B. below). (Keep the authorization in the file.)

The taxpayer (or legal guardian, if the individual is legally incompetent) must sign and date the authorization (SSA-2495).

3. Disclosure to IRS

The Privacy Act prohibits the release of information for law enforcement purposes unless requested in writing by the head of the law enforcement agency. Therefore, do not disclose to IRS regarding another individual using the SSI recipient's SSN on a bank account or other asset regardless of the reason why this was done.

B. Procedure

Follow the procedures below when completing Form SSA-2495. See SI 02310.999, EXHIBIT F.

1. Completion of SSA-2495

1. Complete the top of the form by filling in the claimant/recipient's name and SSN and the name and relationship of the person making the statement (i.e., the taxpayer).

2. Complete the remainder of the form as follows:

   I, (fill in taxpayer's name), of (fill in taxpayer's address), whose taxpayer identification number is (fill in taxpayer's SSN as shown on the alert), authorize the Social Security Administration to disclose information in its possession from: (check the appropriate type(s) of data as specified below) for the year (fill in the tax year to which the data pertain) to (fill in name of individual or organization to whom the taxpayer is authorizing disclosure).

3. Identify the data which may be disclosed by checking the appropriate statement(s) on the SSA-2495. Use more than one if there are multiple tax data interface alerts.

   • For IRS interface cases, check, “The Internal Revenue Services' Information Returns Processing File”;

   • For pension income cases, check, “Forms 1099-R”; and

   • For MEF interface earned income cases, check, “Reports of wages and net earnings from self-employment.”

2. Documentation

Keep the original SSA-2495 in file.

3. References