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The Kansas City RO will certify records associated with subpoenas, law enforcement,
Department of Homeland Security, U.S. Attorney’s Office, and OIG requests. The RO
will review the consent form and notify the requester of any problems.
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If there are no problems, the RO will review the photocopy against the original file
(when applicable) for completeness and disclosure provisions (e.g., child’s claim,
spouse’s SSN, etc.).
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The RO will prepare the certification and cover letter.
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The RO will send the certification and the file back to the FO.
REQUEST FOR CERTIFICATION
Date:
To: Social Security Administration
Center for Disability and Program Support
Regional Privacy Coordinator
Room 1002
601 E 12th Street
Kansas City, MO 64106
Attn: Andrea Rohn
Re: Certification of records for Claimant's Name, SSN ______________
Please certify the photocopies of the attached file. Attached is a copy of the request
and the signed consent form that meets the requirements in GN 03305.003.
Return Certification to: FO Employee Name ________________________
I can be reached at: ___________________________
Field Office Address: DO, DOC ______________________
Address 1 _______________________
Address 2 _______________________
City, State, ZIP ______________________