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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
                  
              
         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 ______________________